Objective To explore how to improve the maturation rate of the first arteriovenous fistula (AVF) through rational design of arteriovenous anastomosis. Methods The control group was treated with traditional end-to-side anastomosis of AVF, and the observation group used the formula prediction method to design the end-to-side anastomosis of AVF. The preoperative cephalic vein diameter and radial artery diameter, radial artery incision length, postoperative anastomotic diameter, postoperative cephalic vein outflow tract diameter, postoperative brachial artery blood flow, and AVF maturity rate were compared between the two groups. Results There were no significant differences in preoperative cephalic vein diameter (F=2.516, P=0.794) and postoperative radial artery diameter (F=0.381, P=0.861) between control group and observation group. The radial artery incision length was shorter in control group than in observation group (F=0.099, P＜0.001). In control group after the operation for 14, 28 and 42 days, the anastomotic diameter was smaller (F=3.812, 1.735 and 1.487 respectively; P＜0.001), the cephalic vein diameter was narrower (F=0.233, 1.442 and 0.002 respectively; P=0.012, 0.024 and ＜0.001 respectively), and the brachial artery blood flow was lower (F=2.287, 1.121 and 0.019 respectively; P＜0.001, =0.008 and =0.001 respectively), as compared with those in observation group. The fistula maturation rate was lower in control group than in observation group after operation for 28 and 42 days (c2=4.167 and 3.990, P=0.041 and 0.046). Conclusions The design of fistula anastomosis using the formula prediction method is beneficial to improve the maturation rate of the first AVF.
LONG Huang-Zhe
,
MO Xiong
,
YANG Peng
,
LI Mei
. The effect of formula prediction method on the design of end-to-side anastomosis of arteriovenous fistula[J]. Chinese Journal of Blood Purification, 2024
, 23(10)
: 775
-778
.
DOI: 10.3969/j.issn.1671-4091.2024.10.010
[1] Hakim R, Hielfarb J.Hemodialysis access failure: a call to action. Kidney Int. 1998 Oct; 54(4):1029-40.[J].Kidney Int, 1988, 54(4):1029-1040
[2]中国医院协会血液净化中心分会血管通路工作组.中国血液透析用血管通路专家共识(第2版)[J]. 中国血液净化.2019, 18(6):365-381.DOI:10.3969/j.issn.1671-4091.2019.06.001.[J].中国血液净化, 2019, 18(6):365-381
[3] Wilmink T.Vascular Access: Clinical Practice Guidelines of the European Society for Vascular Surgery. Eur J Vasc Endovasc Surg. 2018 Jun; 55(6):753-754. doi: 10.1016/j.ejvs.2018.04.004.[J].Eur J Vasc Endovasc Surg, 2018, 55(6):753-754
[4] Lok CE, Huber TS, Lee T, Shenoy S, Yevzlin AS, et al.National Kidney Foundation. KDOQI Clinical Practice Guideline for Vascular Access: 2019 Update. Am J Kidney Dis. 2020 Apr; 75(4 Suppl 2):S1-S164.[J].Am J Kidney Dis, 2020, 74(4):S1-S164
[5]徐元恺, 甄景琴, 张文云, 等.前臂腕部自体动静脉内瘘建立后的动脉重构研究[J].中华血管外科杂志, 2017, 2(3):164-167
[6]施娅雪.如何提高自体动静脉瘘的成熟[J].中国血管外科杂志电子版, 2016, 8(4):252-255
[7] Feldman HI, Joffe M, Rosas SE, Burns JE, Knauss J, Brayman K.Predictors of successful arteriovenous fistula maturation. Am J Kidney Dis. 2003 Nov; 42(5):1000-12. doi: 10.1016/j.ajkd.2003.07.003.[J].Am J Kidney Dis, 2003, 42(5):1000-1012
[8]何强, 李贵森, 康志敏, 等.影响动静脉内瘘成熟的因素探讨[J].中国血液净化, 2009, 8(7):369-371
[9]李月红, 于仲元, 王玉柱, 等.例尿毒症病人内瘘成熟影响因素分析[J].中国血液净化, 2002, 1(2):11-14
[10]McGrogan DG, Maxwell AP, Khawaja AZ, Inston NG.Current tools for prediction of arteriovenous fistula outcomes. Clin Kidney J. 2015 Jun; 8(3):282-9. doi: 10.1093/ckj/sfv019. Epub 2015 Apr 2. PMID: 26034589; PMCID: PMC4440466.[J].Clin Kidney J, 2015, 8(3):282-289
[11]Kaysen GA, Don BR.Factors that affect albumin concentration in dialysis patients and their relationship to vascular disease[J]. Kidney Int Suppl, 2003(84): S94-S97.[J].Kidney Int Suppl, 2003, 84(1):S94-S97
[12]Roy-Chaudhury P, Sukhatme VP, Cheung AK.Hemodialysis vascular access dysfunction: a cellular and molecular viewpoint. J Am Soc Nephrol. 2006 Apr; 17(4):1112-27. doi: 10.1681/ASN.2005050615.[J].J Am Soc Nephrol, 2006, 17(4):1112-1127
[13]谭一伟, 刘乃波.改良动静脉内瘘术在例慢性肾衰血液透析患者中的应用[J].中日友好医院学报, 2001, 15(3):131-133
[14]王慧, 孙秀丽, 吴红梅, 等.新建立自体动静脉内瘘首次穿刺时间对内瘘预后影响的系统评价和分析[J].中国血液净化, 2018, 17(2):107-113
