Eguare E, Tierney S, Maher R, Creamer M, Grace P, Cronin C J, Burke P
Dept of Surgery and The Haemodialysis Unit, Regional General Hospital, Dooradoyle, Limerick.
Ir J Med Sci. 2006 Jan-Mar;175(1):24-8. doi: 10.1007/BF03168995.
The development of regional dialysis units and the expanding indications for dialysis has led to increased demand for vascular access surgery. Consequently, the provision and maintenance of access, and the management of related complications has created a considerable burden on vascular surgical units in hospitals providing renal replacement therapy (RRT).
The objectives of our study were to review our experience with a variety of vascular access modalities for haemodialysis and to quantify the associated surgical workload.
We reviewed our experience in a consecutive group of dialysis patients who had access surgery for RRT in a regional hospital setting.
Between January 1995 and January 2000, 69 patients entered the long-term dialysis programme in the Mid-Western region (population = 320,000). Of the 158 procedures performed, 138 (87%) were for access creation, and 20 (13%) related to access revision procedures. Twenty patients (29%) developed a total of 30 access related complications. Vascular access procedures accounted for 10% of the vascular surgical workload (1598 procedures) in the five-year period.
Vascular access is an important part of the haemodialysis services and surgical expertise should be available at local level to cope with likely demand.
区域透析单位的发展以及透析适应证的不断扩大，导致血管通路手术的需求增加。因此，血管通路的建立与维护以及相关并发症的处理给提供肾脏替代治疗（RRT）的医院血管外科单位带来了相当大的负担。
我们研究的目的是回顾我们在多种血液透析血管通路方式方面的经验，并量化相关的手术工作量。
我们回顾了在一家区域医院环境中为接受RRT而进行血管通路手术的一组连续性透析患者的经验。
1995年1月至2000年1月期间，中西部地区（人口32万）有69例患者进入长期透析项目。在158例手术中，138例（87%）用于建立血管通路，20例（13%）与血管通路修复手术有关。20例患者（29%）共出现30例与血管通路相关的并发症。在这五年期间，血管通路手术占血管外科工作量（1598例手术）的10%。
血管通路是血液透析服务的重要组成部分，地方层面应具备手术专业知识以应对可能的需求。
