Fry P D, Allardyce D B
Can J Surg. 1979 Mar;22(2):154-5, 158.
A polytetrafluoroethylene (PTFE) graft from the brachial artery to the axillary vein may provide a safe and trouble-free means of vascular access in selected patients requiring long-term intravenous feeding in the hospital setting. This route for the administration of solutions supplying total parenteral nutrition (TPN) should be considered in persons whose requirement for parenteral feeding is likely to extend over many months and in whom there are other sources of bacteremia which can imitate or be confused with infection of a conventional central venous feeding line. In a 52-year-old man an 8-mm PTFE graft was anastomosed end-to-side to the brachial artery and the axillary vein and brought through a subcutaneous tunnel on the medial aspect of the upper arm. Access to it was obtained by intermittent puncture with a no. 21 butterfly needle. Hyperosmolar TPN solutions flowed easily by gravity drip into the shunt. The graft seemed resistant to infection. This form of vascular access appears to exclude parenteral feeding lines, solutions and catheters as sources of sepsis.
在医院环境中，对于某些需要长期静脉营养的患者，将聚四氟乙烯（PTFE）移植物从肱动脉连接至腋静脉可为其提供一种安全且无故障的血管通路方式。对于那些肠外营养需求可能持续数月，且存在其他可模拟或混淆传统中心静脉营养管感染的菌血症来源的患者，应考虑采用这种输注全胃肠外营养（TPN）溶液的途径。在一名52岁男性患者中，将一段8毫米的PTFE移植物端侧吻合至肱动脉和腋静脉，并经上臂内侧的皮下隧道引出。通过使用21号蝶形针间歇性穿刺来实现对其的使用。高渗TPN溶液通过重力滴注可轻松流入分流管。该移植物似乎对感染具有抵抗力。这种血管通路形式似乎排除了肠外营养管、溶液和导管作为败血症来源的可能性。
