Beathard Gerald A, Jennings William C, Wasse Haimanot, Shenoy Surendra, Hentschel Dirk M, Abreo Kenneth, Urbanes Aris, Nassar George, Dolmatch Bart, Davidson Ingemar, Asif Arif
University of Texas Medical Branch, Galveston, TX, USA.
School of Community Medicine, The University of Oklahoma, Tulsa, OK, USA.
J Vasc Access. 2020 Sep;21(5):543-553. doi: 10.1177/1129729819894774. Epub 2019 Dec 30.
Although not common, hemodialysis access-induced distal ischemia is a serious condition resulting in significant hemodialysis patient morbidity. Patients with signs and symptoms suggestive of hand ischemia frequently present to the general and interventional nephrologist for evaluation. In order to care for these cases, it is necessary to understand this syndrome and its management. Most cases can be managed conservatively without intervention. Some cases requiring intervention may be treated using techniques within the scope of practice of the interventional nephrologists while other cases require vascular surgery. In order for the interventional nephrologists to evaluate and manage these cases in a timely and appropriate manner, practice guidelines are presented.
尽管并不常见，但血液透析通路引起的远端缺血是一种严重的病症，会导致血液透析患者出现明显的发病情况。有手部缺血迹象和症状的患者经常会去找普通内科医生和介入肾科医生进行评估。为了处理这些病例，有必要了解这种综合征及其治疗方法。大多数病例可以通过保守治疗而无需干预。一些需要干预的病例可以采用介入肾科医生业务范围内的技术进行治疗，而其他病例则需要进行血管外科手术。为了使介入肾科医生能够及时、适当地评估和处理这些病例，现提出实践指南。
