Elfström J, Thomsen M
Scand J Urol Nephrol. 1981;15(3):323-6. doi: 10.3109/00365598109179626.
The most common route of access in haemodialysis is the conventional radio-cephalic fistula at the wrist. Some patients are better suited for a graft procedure, however. In order to select the most appropriate approach preoperative assessment of the veins is important. Certain observations made at operation may also be helpful. We have measured the vessel sizes and estimated blood flow before and after establishment of the fistula. 36 radio-cephalic fistulae were made in a series of patients not selected with regard to the condition of the veins, in order to find characteristics indicating a poor prognosis for the fistula. There were 8 early failures (22%), and another fistula ceased to function within 6 months. We found that a fistula flow of less than 40 ml/min immediately after construction was associated with a 70% risk of early failure, and no fistulae with such a flow rate survived 6 months. Neither vessel diameters nor preoperative blood flow in the radial artery influenced the risk of early failure.
血液透析最常见的血管通路是手腕处传统的桡动脉-头静脉内瘘。然而，有些患者更适合采用移植手术。为了选择最合适的方法，术前对静脉进行评估很重要。手术中进行的某些观察也可能有所帮助。我们在建立内瘘前后测量了血管大小并估计了血流量。在一系列未根据静脉状况进行选择的患者中制作了36个桡动脉-头静脉内瘘，以便找出表明内瘘预后不良的特征。有8个早期失败病例（22%），另有一个内瘘在6个月内失去功能。我们发现，构建后立即出现内瘘血流量低于40 ml/分钟与70%的早期失败风险相关，且没有如此血流量的内瘘能存活6个月。桡动脉的血管直径和术前血流量均未影响早期失败的风险。
