Tordoir J H, Herman J M, Kwan T S, Diderich P M
Department of Surgery, Catharina Hospital, Eindhoven, The Netherlands.
Eur J Vasc Surg. 1988 Feb;2(1):3-7. doi: 10.1016/s0950-821x(88)80099-9.
During a 10-year period vascular access in 86 patients receiving long-term haemodialysis was provided by the insertion of 100 polytetrafluoroethylene grafts. In 24 patients (28%) the PTFE prosthesis was used as a primary access operation; 62 patients (72%) had had previous access procedures. Early thrombosis and infection led to graft failure in eight patients. Late fistula occlusion developed in 67 instances in 39 fistulae. Thrombectomies were performed in 53 fistulae with good result in 46 (86.8%). Infection after puncture was seen in nine grafts and was treated by incision and drainage (33%) or graft removal (67%). False aneurysms developed in six patients; prolonged haemorrhage from the puncture site occurred in one patient and haemodynamic complications (ischaemic steal syndrome; venous hypertension) developed in four. The cumulative patency of PTFE AV fistulae was 74% after 1 year; 59% after 2 and 3 years and 47% after a follow-up of 5 years. Despite the high rate of complications the PTFE AV fistula has proved an acceptable technique in secondary access surgery for haemodialysis.
在10年期间，为86例接受长期血液透析的患者插入了100条聚四氟乙烯移植物，以建立血管通路。24例患者（28%）将聚四氟乙烯假体用作初次通路手术；62例患者（72%）曾接受过先前的通路手术。早期血栓形成和感染导致8例患者的移植物失败。39条动静脉内瘘中有67例出现晚期内瘘闭塞。对53条内瘘进行了血栓切除术，46例（86.8%）效果良好。9条移植物出现穿刺后感染，通过切开引流（33%）或移除移植物（67%）进行治疗。6例患者出现假性动脉瘤；1例患者穿刺部位出现长时间出血，4例出现血液动力学并发症（缺血性窃血综合征；静脉高压）。聚四氟乙烯动静脉内瘘1年后的累积通畅率为74%；2年和3年后为59%，随访5年后为47%。尽管并发症发生率很高，但聚四氟乙烯动静脉内瘘已被证明是血液透析二次通路手术中一种可接受的技术。
