【摘要】目的总结GORE® ACUSEAL 即穿型人工血管动静脉内瘘的初步临床应用结果。方法回顾性分析笔者在2016 年12 月～2018 年9 月收治的37 例GORE® ACUSEAL 即穿型人工血管动静脉瘘的临床资料，总结其首次穿刺时间、通畅率及并发症的发生率。结果本组男13 例，女24 例，平均年龄(62.30±10.24)岁，建立上肢即穿型人工血管(arteriovenous graft，AVG)31 例，下肢6 例。手术成功率100%，无围手术期并发症。术后首次穿刺时间14h～42d，平均穿刺时间(84.26±172.56)h。穿刺相关皮下血肿3例。平均随访时间(299.0±141.3)d，随访率100%，血栓10 例，狭窄6 例，感染2 例，局部皮肤坏死2 例，死亡2 例，无血清肿、假性动脉瘤、窃血综合征发生。半年及1 年初级通畅率分别为65.1%±8.2%和46.9%±10.1%，初级辅助通畅率分别为76.8%±7.2%和69.6%±8.2%，1 年次级通畅率为94.6%±3.7%。结论即穿型人工血管术后可立刻穿刺，避免过渡期中心静脉置管，缩短了导管的留置时间，在临床有一定的应用价值。
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