俯卧位有助于建立尺侧-贵要静脉动静脉内瘘。
Prone Position Facilitates Creation of Ulnar-Basilic Arteriovenous Fistula.
作者信息
Gołębiowski Tomasz, Jerzak Patryk, Letachowicz Krzysztof, Konieczny Andrzej, Kusztal Mariusz, Gołębiowski Maciej, Banasik Mirosław, Sznajder Katarzyna, Krajewska Magdalena
机构信息
Department of Nephrology and Transplantation Medicine, Wroclaw Medical University, Borowska 213, 50-556 Wroclaw, Poland.
Department of Radiology, University of Opole, 45-052 Opole, Poland.
出版信息
J Clin Med. 2022 May 6;11(9):2610. doi: 10.3390/jcm11092610.
BACKGROUND
The distal ulnar-basilic arteriovenous fistula (UBAVF) is a rarely used alternative type of vascular access for haemodialysis. The location of the vein on the back aspect of the forearm forces an extremely uncomfortable external rotation of the upper limb during surgery when the patient is in a supine position.
METHODS
We present a new approach towards creating UBAVF, which involves placing the patient in the prone position, thus eliminating the aforementioned inconvenience. The procedure was performed and described in a 46-year-old patient with chronic kidney disease (CKD) due to diabetic nephropathy. In the period from September 2021 to December 2021, we created an additional three UBAVFs with such modifications.
RESULTS
All fistulas were patent both immediately after the procedure and 2 weeks after surgery.
CONCLUSIONS
The prone position may improve the comfort of both the operator and the patient during the procedure. On top of this, it may have a positive impact on the quality of the arteriovenous anastomosis.
背景
尺动脉-贵要静脉远端动静脉内瘘（UBAVF）是一种很少使用的血液透析血管通路替代类型。在前臂背侧的静脉位置使得患者仰卧位手术时上肢会出现极其不适的外旋。
方法
我们提出了一种创建UBAVF的新方法，即让患者处于俯卧位，从而消除上述不便。该手术在一名因糖尿病肾病导致慢性肾脏病（CKD）的46岁患者身上进行并描述。在2021年9月至2021年12月期间，我们通过这种改良方法又创建了另外3个UBAVF。
结果
所有内瘘在术后即刻及术后2周均通畅。
结论
俯卧位可能会提高手术过程中术者和患者的舒适度。除此之外，它可能对动静脉吻合质量产生积极影响。
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