Department of Surgery, University of South Carolina School of Medicine-Greenville, Greenville Hospital System/University Medical Center, Greenville, SC 29605, USA.
Semin Vasc Surg. 2011 Jun;24(2):89-95. doi: 10.1053/j.semvascsurg.2011.05.003.
The emphasis on increasing the use of autogenous hemodialysis access in the United States has clearly changed the practice pattern of vascular surgeons during the past decade. However, this change has also been associated with an increased use of cuffed dialysis catheter and a decrease in the autogenous access maturation rate. Future efforts to increase autogenous access use will be hampered, in part, by the characteristics and comorbidities of the aging hemodialysis population and system-wide health care delivery issues, such as late referral for vascular access. As a result, prosthetic access will continue to play an important role in providing vascular access for the US hemodialysis population. This article reviews contemporary trends and evidence-based literature related to autogenous and prosthetic access procedures, as well as factors that influence access choice.
在美国，强调增加自体血液透析通路的使用显然改变了血管外科医生在过去十年中的实践模式。然而，这种变化也与带袖套的透析导管的使用增加以及自体通路成熟率的下降有关。未来增加自体通路使用的努力将受到部分阻碍，这部分是由于老龄化血液透析人群的特点和合并症以及全系统医疗保健提供问题，例如血管通路的延迟转诊。因此，人造通路将继续在为美国血液透析人群提供血管通路方面发挥重要作用。本文回顾了与自体和人造通路手术相关的当代趋势和循证文献，以及影响通路选择的因素。
