Derakhshanfar A, Gholyaf M, Niayesh A, Bahiraii S
Department of Surgery, Besat Hospital, Hamadan University of Medical Science, Hamadan, Iran.
Saudi J Kidney Dis Transpl. 2009 Sep;20(5):872-5.
The arterio-venous fistula (AVF) remains the ideal vascular access for patients on maintenance hemodialysis (HD). The aim of this study was to evaluate the complications associated with AVF and was conducted at the Ekbatan Hospital dialysis center in the years 2006 and 2007. In this descriptive cross-sectional study, 90 patients with AVF were enrolled. For each patient, data related to age, gender, time of AVF surgery, duration of renal failure, duration on dialysis, number of fistulas and their sites and, data related to complications of AVF were entered in a check list and analyzed with SPSS software (version :11). Majority of the study patients were in the age-group of 41-60 years and there was a male preponderance (56.7%). The mean duration from the time AVF surgery was performed was 26 +/- 29.8 months, the mean duration of ESRD was 48.1 +/- 45.52 months and the mean duration on dialysis was 28.6 +/- 30.81 months. Most of the patients (75.6%) had undergone AVF surgery only once and in the majority (61.1%), the fistula was in the left arm. The most frequent complication seen in our patients was aneurysm (51%), followed by venous hyper-tension (16.7%), infection (4.4%), thrombosis (3.3%) and arterial steal syndrome (1.1%). Our study indicates that the prevalence of complications of AVF is high and greater attention should be paid to the prevention of these complications. Early diagnosis and appropriate treatment is essential to improve the quality of life in patients on HD.
动静脉内瘘（AVF）仍然是维持性血液透析（HD）患者理想的血管通路。本研究旨在评估与动静脉内瘘相关的并发症，于2006年和2007年在埃克巴坦医院透析中心开展。在这项描述性横断面研究中，纳入了90例动静脉内瘘患者。为每位患者记录与年龄、性别、动静脉内瘘手术时间、肾衰竭持续时间、透析时间、内瘘数量及其部位相关的数据，以及与动静脉内瘘并发症相关的数据，并录入检查表，使用SPSS软件（版本：11）进行分析。研究中的大多数患者年龄在41 - 60岁之间，男性占多数（56.7%）。动静脉内瘘手术至研究时的平均时间为26 ± 29.8个月，终末期肾病（ESRD）的平均持续时间为48.1 ± 45.52个月，透析的平均时间为28.6 ± 30.81个月。大多数患者（75.6%）仅接受过一次动静脉内瘘手术，大多数（61.1%）的内瘘位于左臂。我们的患者中最常见的并发症是动脉瘤（51%），其次是静脉高压（16.7%）、感染（4.4%）、血栓形成（3.3%）和动脉窃血综合征（1.1%）。我们的研究表明，动静脉内瘘并发症的发生率很高，应更加重视这些并发症的预防。早期诊断和适当治疗对于提高血液透析患者的生活质量至关重要。
