Chui A K, Chiu E Y, White E A, Yumiba T
Department of Surgery, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, Hong Kong.
Hong Kong Med J. 2000 Sep;6(3):312-5.
To review the practice of concurrent chronic ambulatory peritoneal dialysis catheter insertion and arteriovenous fistula formation in patients needing dialysis, we retrospectively assessed the results of arteriovenous fistula procedures, the risk factors for fistula failure, and the selection strategy used to choose which patients with end-stage renal disease would be given dialysis. We analysed the medical records of 136 patients who had first-time arteriovenous fistulae created between 1 July 1986 and 1 May 1994 at a public hospital in Sydney, Australia. As many as 36% of fistulae were never used (24.5% due to primary failure) and 30.1% of the fistulae used had to be abandoned for various reasons. In addition, 22.8% of patients experienced complications, the most common being thrombosis and stenosis. None of the factors associated with fistula formation were significant in terms of fistula patency rates, but smokers and female patients had inferior fistula patency rates. Whereas the overall results were satisfactory, the practice of concurrent chronic ambulatory peritoneal dialysis catheter insertion and arteriovenous fistula formation to give vascular access for dialysis is questionable.
为了回顾在需要透析的患者中同时进行慢性非卧床腹膜透析导管插入术和动静脉内瘘形成术的实践情况，我们回顾性评估了动静脉内瘘手术的结果、内瘘失败的危险因素以及用于选择哪些终末期肾病患者进行透析的选择策略。我们分析了1986年7月1日至1994年5月1日期间在澳大利亚悉尼一家公立医院首次进行动静脉内瘘手术的136例患者的病历。多达36%的内瘘从未使用过（24.5%是由于原发性失败），30.1%已使用的内瘘因各种原因不得不废弃。此外，22.8%的患者出现并发症，最常见的是血栓形成和狭窄。就内瘘通畅率而言，与内瘘形成相关的因素均无显著意义，但吸烟者和女性患者的内瘘通畅率较低。尽管总体结果令人满意，但同时进行慢性非卧床腹膜透析导管插入术和动静脉内瘘形成术以提供透析血管通路的做法仍值得怀疑。
