McIntosh C S, Petrie J C, Macleod M
Br Med J. 1969 Dec 20;4(5685):717-20. doi: 10.1136/bmj.4.5685.717.
The occurrence of infection in the tissues surrounding external arteriovenous shunts was studied and die important relationship of pyogenic infection to clotting was confirmed. The local application of fusidic add tulle and lanolin greatly reduced the occurrence of both infection and clotting and the need for cannula replacement.Urokinase used for declotting shunts when standard procedures had failed, restored blood flow whether dotting was related to infection or to local vascular factors. This treatment is not advised when clotting is associated with a local abscess, as it may make cannula replacement necessary. Severe local vascular factors, such as metastatic calcification, Raynaud's phenomenon, and venous stenosis, may lead to poor blood flow, so that despite clot lysis elective cannula replacement or the creation of a subcutaneous arteriovenous fistula is required.
对外周动静脉分流周围组织感染的发生情况进行了研究，并证实了化脓性感染与凝血之间的重要关系。局部应用夫西地酸纱布和羊毛脂可大大降低感染和凝血的发生率以及更换套管的必要性。当标准程序失败时，使用尿激酶溶解分流处的血栓，无论血栓形成是与感染还是局部血管因素有关，均可恢复血流。当血栓形成与局部脓肿相关时，不建议采用这种治疗方法，因为这可能需要更换套管。严重的局部血管因素，如转移性钙化、雷诺现象和静脉狭窄，可能导致血流不畅，因此尽管血栓溶解，仍需要选择性更换套管或建立皮下动静脉瘘。
