Kidney Disease Center, Sir Run Run Hospital, Nanjing Medical University, Nanjing, Jiangsu, China (mainland).
Med Sci Monit. 2020 May 29;26:e920421. doi: 10.12659/MSM.920421.
BACKGROUND The aim of this study was to evaluate the efficacy and safety of use of a ureteral catheter during arteriovenous fistula in end-stage renal disease patients with poor vascular status. MATERIAL AND METHODS Fifty patients with standard arteriovenous fistulas at Sir Run Run Hospital of Nanjing Medical University from April 2018 to April 2019 were included. Based on the use of ureteral catheter exploration and tourniquet hydraulic dilatation, patients were divided into study and control groups. The operative success rate, inner diameter of cephalic vein 1 day post-operatively, blood flow in the internal fistula, patency rate and blood flow in the internal fistula 3 months post-operatively, and complications 6 months post-operatively were compared between the 2 groups. RESULTS There were 25 cases in each group, with no significant differences in sex or age between the 2 groups. The operative success rate in the study group was higher than in the control group (96% vs. 88%) (F=1.087, P=0.297). The patency rates at 3 and 6 months post-operatively in the study group were higher than in the control group. The inner diameter of the cephalic vein 1 day post-operatively, the blood flow in the internal fistula, and the complications 6 months post-operatively in the study group were significantly superior to those of the control group (P=0.002). CONCLUSIONS In standard arteriovenous fistula, especially vascular catheter exploration of unhealthy vessels, the application of a ureteral catheter can improve the operative success rate and promote internal fistula maturity, with low cost and ease of use.
本研究旨在评估在血管状况不佳的终末期肾病患者中使用输尿管导管在动静脉瘘中的疗效和安全性。
2018 年 4 月至 2019 年 4 月,南京医科大学附属逸夫医院共有 50 例标准动静脉瘘患者纳入研究。根据输尿管导管探查和止血带水压扩张的使用,患者被分为研究组和对照组。比较两组的手术成功率、术后 1 天头静脉内径、内瘘血流量、术后 3 个月通畅率和内瘘血流量以及术后 6 个月并发症。
每组各 25 例,两组患者性别和年龄比较差异无统计学意义。研究组的手术成功率高于对照组(96% vs. 88%)(F=1.087,P=0.297)。研究组术后 3 个月和 6 个月的通畅率均高于对照组。研究组术后 1 天头静脉内径、内瘘血流量和术后 6 个月并发症均明显优于对照组(P=0.002)。
在标准动静脉瘘中,特别是在不健康血管的血管导管探查中,应用输尿管导管可以提高手术成功率,促进内瘘成熟,且成本低、易于使用。