Objective To explore the application of small inner diameter cephalic vein in construction of autogenous arteriovenous fistula (AVF). Methods A retrospective study was conducted on patients undergoing AVF construction at the Department of Nephrology, Chongqing Songshan Hospital from January 1, 2022 to December 31, 2023. According to the inner diameter of the cephalic vein at the preoperative surgical site, they were divided into a small inner diameter group and a conventional inner diameter group. The operation was performed by one surgeon. Brachial artery flow rate at 8 weeks after operation, maximum pump-controlled blood flow during dialysis, and urea clearance rate were compared between the two groups. Statistical analysis was performed using SPSS 22.0 software, and P＜0.05 was considered to be statistically significant. Results By comparing maturity and use of AVF between the small inner diameter group and the conventional inner diameter group, we found that there were no significant differences in brachial artery flow rate (χ2=2.009, P=0.156), dialysis maximum pump-controlled blood flow rate (χ2=2.509, P=0.113), and urea clearance rate (χ2=2.979, P=0.084) after 8 weeks between the two groups. Conclusion There were no statistical differences in maturity and use of AVF between the small inner diameter group and the conventional inner diameter group. For patients with preoperative cephalic vein diameter less than 2.0 mm, but greater than or equal to 1.5 mm, the success rate of AVF construction is still high, warranting to be tried surgically.
FANG Fan
,
YU Wen-Hong
,
CHEN Liang-Jing
. Application of small inner diameter cephalic vein in construction of autogenous arteriovenous fistula[J]. Chinese Journal of Blood Purification, 2025
, 24(06)
: 504
-507
.
DOI: 10.3969/j.issn.1671-4091.2025.06.013
[1]Luxia Zhang,Fang Wang,Li Wang,et al.Prevalence of chronic kidney disease in china:a cross-sectional survey[J].Lancet,2012(9838).
[2]郝思嘉.慢性肾脏病医疗费用及影响因素研究[D]上海市：海军军医大学，2023:8.
[3]余丹霞, 黄 红,邱 强.维持性血液透析患者左心室舒张功能障碍的危险因素分析［J］.中国血液净化,2024, 23, (3):189-192.
[4]金其庄，王玉柱，叶朝阳，等 . 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.
[5]Thamer M, Lee TC, Wasse H, et al. Medicare costs associated with arteriovenous fistulas among US hemodialysis patients[J]. Am J Kidney Dis, 2018, 72(1): 10-18.
[6]李海磊,陈燿志,崔东哲,等. 影响自体桡动脉头静脉瘘成熟的因素[J]. 中华血管外科杂志,2020,05(3):191-196
[7]Gaetano Alfano1 , Francesco Fontana1 , Mario Iannaccone2 , Patrizia Noussan2 , Gianni Cappelli Preoperative management of arteriovenous fistula (AVF) for hemodialysis，[J] Vasc Access 2017; 18 (6): 451-463.
[8]陈香美主编.血液净化标准操作规程(2021 版)[M]. 第一版. 北京：人民卫生出版社，2021:184.
[9]赵德龙.维持性血液透析患者流行病学调查及生存预后相关性分析[D].北京：解放军医学院.2016；15.
[10]张楠楠.维持性血液透析患者流行病学调查及生存分析[D].山西：山西医科大学.2018:7-24.
[11]惠鑫，卞雪芹，丁 昊，等.基层医院维持性血液透析患者血管通路使用现状调查[J].中国血液净化.2024,23(2):138-141.
[12]华参.维持性血液净化血管通路失功的临床监测和实验研究[D].上海：第二军医大学，2008：2.
[13]惠鑫，卞雪芹，丁 昊，等.基层医院维持性血液透析患者血管通路使用现状调查[J].中国血液净化.2024,23(2):138-141.
[14]Kim DH, Park JI, Lee JP, et al. The effects of vascular access types on the survival and quality of life and depression in the incident hemodialysis patients. Ren Fail. 2020;42(1):30-39.
[15]Firouraghi N, Ezzatzadegan Jahromi S, Sami A, et al. Duration of Vascular Access Usage and Patient Survival in the First Year of Hemodialysis. Iran J Kidney Dis. 2019;13(6):398-403
[16]肖祥,马荣,奉娅,等.不同血管通路血液透析患者的预后分析[J].西部医学,2020,(10):1504-1508.
[17]安娜,李洪,陈汝满,等.不同血管通路类型对维持性血液透析患者生存影响的研究[J].中国血液净化,2022,21(09):681-685.
[18]翟蕾,段淑敏,韩玲玉,等.3种血管通路在老年维持性血液透析患者中的应用效果比较[J].安徽医学,2023,44(03):293-297.
[19]史珂慧,严森辉,党喜龙,等.超声下经皮腔内血管成形术治疗自体动静脉内瘘成熟不良[J].肾脏病与透析肾移植杂志,2023,32(01):21-26.
[20]刘伟,冯剑,王宏泽.经皮腔内血管成形术在血液透析促进动静脉内瘘成熟中的应用[J].浙江实用医学,2020,25(01):36-38.
[21]李慧,朱一枫,李晶晶,等.经皮腔内血管成形术促进动静脉内瘘成熟的疗效分析[J].中国血液净化,2020,19(02):120-123.
[22]田立晴.术中动静脉直径对维持性血液透析患者自体动静脉内瘘通畅性的影响[D].南昌：南昌大学,2023：10-11.
[23]Kordzadeh A , Askari A , Hoff M ,et al.The Impact of Patient Demographics, Anatomy, Comorbidities, and Peri-operative Planning on the Primary Functional Maturation of Autogenous Radiocephalic Arteriovenous Fistula[J].European Journal of Vascular & Endovascular Surgery, 2017, 53(5):726-732.
[24]Feng R,Wang S , Chang G，et al.The feasibility of small-caliber veins for autogenous arteriovenous fistula creation: A single-center retrospective study.[J] Frontiers in Cardiovascular Medicine,2023,Jan:1-9.
