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目的:总结西宁地区(2 260m)前臂自体动静脉内瘘进行血液透析的经验,探讨在其应用过程中的体会和并发症的防治。方法:对采用前臂腕部自体动静脉内瘘术建立血管通路的血液透析患者进行分析,探讨建立前臂内瘘的血管条件、手术方式、近远期通畅率、并发症及临床处理原则等。结果:146例患者中,143例手术成功建立血管内瘘,手术一次成功率98%,内瘘初级通畅率97.9%。内瘘使用后0.5年和1年通畅率分别为97%和96%。结论:前臂腕部自体动静脉内瘘术制作简便,远期通畅率高,是血液透析血管通路的首选。
OBJECTIVE: To summarize the experience of hemodialysis in 2252m forearm arteriovenous fistula in Xining area and to explore the experience and prevention and treatment of complications in its application. Methods: The hemodialysis patients with vascular access established by forearm autogenous arteriovenous fistula were analyzed to explore the vascular conditions, the surgical approach, the patency in the short and long term, the complication and the principle of clinical treatment. Results: Out of 146 patients, 143 cases of vascular fistula were successfully established. The successful rate of primary fistula surgery was 98% and the primary patency rate of internal fistula was 97.9%. The 0.5% and 1 year patency rates after internal fistula use were 97% and 96%, respectively. Conclusion: Arteriovenous fistula of forearm wrist is easy to make and has good long-term patency rate. It is the first choice of hemodialysis vascular access.