Dodson T F, Stewart M T, Martin L G
Department of Surgery, Emory University School of Medicine, Atlanta, GA.
J Vasc Surg. 1993 Apr;17(4):759-61.
In children with chronic renal failure, vascular access for hemodialysis is difficult because of the small size of the vessels and the requirement for substantial blood flow through the fistula or graft. As the child grows older, the ease of constructing a satisfactory access usually increases as the vessels increase in size. Unfortunately, this increased ease is often offset by the paucity of suitable access sites because the larger peripheral sites have already been used with only transient success. We report a child with chronic renal failure since 1 month of age with no peripheral sites available because of prior failed procedures who underwent placement of polytetrafluoroethylene limbs to the aorta and vena cava at the age of 6 years. He has continued on hemodialysis for the past 4 1/2 years with this technique of vascular access.
在慢性肾衰竭患儿中，由于血管细小且需要通过动静脉内瘘或移植物实现大量血流，进行血液透析的血管通路建立较为困难。随着患儿年龄增长，血管变粗，构建满意通路的难度通常会降低。不幸的是，这种难度降低常常被合适的通路部位不足所抵消，因为较大的外周部位已使用过但仅取得短暂成功。我们报告一例自1月龄起即患有慢性肾衰竭的患儿，因既往手术失败，6岁时已无可用的外周部位，遂接受了聚四氟乙烯人工血管连接至主动脉和腔静脉的手术。在过去4年半的时间里，他一直通过这种血管通路技术进行血液透析。
