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血液透析通路的急性问题:血栓形成、动脉瘤、有症状的高流量瘘管以及与中央导管相关的并发症。

Acute problems of hemodialysis access: Thrombosis, aneurysms, symptomatic high-flow fistulas, and complications related to central lines.

机构信息

Vascular Surgery Unit, Department of Surgery and Morphological Sciences, Circolo University Teaching Hospital, University of Insubria, ASST Settelaghi, Via Guicciardini, 9, 21100 Varese, Italy.

Vascular Surgery Unit, ASST Fatebenefratelli Sacco, Milan, Italy.

出版信息

Semin Vasc Surg. 2023 Jun;36(2):300-306. doi: 10.1053/j.semvascsurg.2023.04.008. Epub 2023 Apr 29.

Abstract

Hemodynamic complications frequently affect vascular access and are important causes of morbidity and mortality. We present a review of acute complications affecting vascular accesses, focusing on classical and new treatments. Acute complications in hemodialysis vascular access are often underestimated and undertreated, and can present a challenge for both vascular surgeons and anesthesiologists. Accordingly, we considered different anesthesiologic approaches to both hemorrhagic and nonhemorrhagic patients. A strict collaboration among nephrologists, surgeons, and anesthesiologists can potentially improve prevention and management of acute complications and quality of life.

摘要

血流动力学并发症常影响血管通路,是发病率和死亡率的重要原因。我们回顾了影响血管通路的急性并发症,并重点介绍了经典和新的治疗方法。血液透析血管通路的急性并发症常被低估和治疗不足,这对血管外科医生和麻醉医生都是一个挑战。因此,我们考虑了不同的麻醉方法,既适用于出血患者也适用于非出血患者。肾脏病医生、外科医生和麻醉医生之间的密切合作可能会提高急性并发症的预防和管理水平,并改善生活质量。

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