Ahmed Gamal Mustafa, Mansour Mustafa Omran, Elfatih Mohamed, Khalid Khalid Eltahir, Ahmed Mohammed El Imam Mohammed
Department of Surgery, Faculty of Medicine, University of Gezira, Gezira, Sudan.
Saudi J Kidney Dis Transpl. 2012 Jan;23(1):152-7.
A well-functioning arteriovenous fistula (AVF) is essential for the maintenance of hemodialysis (HD) in patients with chronic renal failure. Our aim is to review our experience of creating AVF and to asses its success rate and common complication. A prospective, hospital-based study was conducted on 73 patients (48 males and 25 females) on chronic HD in Gezira Hospital for Renal Diseases and Surgery, from January to July 2007. Their mean age was 43.9 years (range from 18 to 72 years). Seventy-one (97.3%) of the study subjects had been dialyzed before creation of the AVF, 67 (91.8%) of them having undergone HD with temporary access. All patients (n=73) had a native AVF as the permanent vascular access (VA). A primary radiocephalic AVF was created in 78.1% of the patients, cubital fossa in 20.5% and one case had left snuff box AVF (1.4%). Percentage of AVF maturation was reported in 67.1% of the cases within the first six weeks and in 9.6% of the cases AVF never matured. Failure of AVF function occurred in 26% of the cases, due to thrombosis in 20.5% (n=15) and aneurysm in 5.5% of the cases. We conclude that an optimum outcome is likely when there is a multidisciplinary team approach, and early referral to vascular surgery is paramount.
功能良好的动静脉内瘘（AVF）对于慢性肾衰竭患者维持血液透析（HD）至关重要。我们的目的是回顾我们建立AVF的经验，并评估其成功率和常见并发症。2007年1月至7月，在盖齐拉肾病与外科医院对73例接受慢性HD的患者（48例男性和25例女性）进行了一项基于医院的前瞻性研究。他们的平均年龄为43.9岁（范围为18至72岁）。71例（97.3%）研究对象在建立AVF之前已进行透析，其中67例（91.8%）通过临时通路接受HD。所有患者（n = 73）均采用自体AVF作为永久性血管通路（VA）。78.1%的患者建立了头静脉-桡动脉AVF，20.5%建立在肘窝，1例（1.4%）建立了左侧鼻烟窝AVF。67.1%的病例在最初六周内报告了AVF成熟率，9.6%的病例AVF从未成熟。26%的病例发生AVF功能衰竭，其中20.5%（n = 15）是由于血栓形成，5.5%是由于动脉瘤形成。我们得出结论，多学科团队协作时可能会取得最佳结果，早期转诊至血管外科至关重要。
