Iuchtman M, Jacob E T, Boner G, Weiner P
Int Surg. 1981 Jul-Sep;66(3):241-2.
One hundred and twenty-five arteriovenous fistulas for chronic hemodialysis are reviewed and their patency is related to the etiology of terminal uremia and other factors. A significant difference was found between the patency of fistulas of patients with chronic glomerulonephritis (CGN) and those of patients with chronic pyelonephritis (CPN). The average number of A-V fistulas in the CGN group was 1.30, while in those with CPN, 2.14 fistulas per patient necessitated construction. A pattern similar to that of the CGN group was observed in a third group of patients, who had an unclear diagnosis. The average number of fistulas was the same, and the mean survival 20 months in both groups, compared with the four months mean survival in the CPN group. Higher blood pressure levels were observed in the groups with a higher patency rate. The survival of patients with A-V fistulas appears to be related more directly to the etiology of the terminal uremia and care taken during hemodialysis than to the type of vascular connection. Anticoagulation and larger anastomoses are advisable in patients with increased risk of fistula deterioration. These patients should be included in the transplantation priority list.
回顾了125例用于慢性血液透析的动静脉内瘘，并将其通畅情况与终末期尿毒症的病因及其他因素相关联。发现慢性肾小球肾炎（CGN）患者的内瘘通畅情况与慢性肾盂肾炎（CPN）患者的内瘘通畅情况存在显著差异。CGN组患者的平均动静脉内瘘数量为1.30个，而CPN组患者每人需要构建2.14个内瘘。在诊断不明确的第三组患者中观察到了与CGN组相似的模式。两组的平均内瘘数量相同，平均生存期均为20个月，而CPN组的平均生存期为4个月。在通畅率较高的组中观察到了更高的血压水平。动静脉内瘘患者的生存期似乎更直接地与终末期尿毒症的病因以及血液透析期间的护理相关，而不是与血管连接类型相关。对于内瘘恶化风险增加的患者，建议进行抗凝和采用更大的吻合口。这些患者应被列入移植优先名单。
