Horimi H, Kusano E, Hasegawa T, Fuse K, Asano Y
Department of Thoracic and Cardiovascular Surgery, Jichi Medical School, Tochigi, Japan.
ASAIO J. 1996 May-Jun;42(3):177-80.
The present study was performed to evaluate the clinical usefulness of an anatomical snuff box arteriovenous fistula with special reference to its short-term and long-term patency in 139 hemodialysis patients. A snuff box fistula was established in 139 patients, including 39 with diabetic nephropathy (DN group) and 100 with non diabetic nephropathy (non DN Group). Fistula blood flow was measured by Doppler ultrasound in 18 patients. Early and late obstruction was observed in 24 (17%) of the 139 patients. The long-term patency rate of the snuff box fistula in the non DN group was 87% at 57 months, whereas the patency rate at 57 months in the DN group (72%) was significantly (p < 0.05) lower than that in the non DN group. The increase in arterialized vein blood flow in DN patients was less marked than that in the non DN patients. These results suggest that the high prevalence of late obstruction in DN patients may partly be reflected by an insufficient increase of arterialized vein blood flow at the snuff box site.
本研究旨在评估鼻烟窝动静脉内瘘在139例血液透析患者中的临床实用性，特别关注其短期和长期通畅情况。为139例患者建立了鼻烟窝内瘘，其中包括39例糖尿病肾病患者（DN组）和100例非糖尿病肾病患者（非DN组）。通过多普勒超声对18例患者的内瘘血流量进行了测量。139例患者中有24例（17%）出现早期和晚期阻塞。非DN组鼻烟窝内瘘在57个月时的长期通畅率为87%，而DN组在57个月时的通畅率（72%）显著低于非DN组（p<0.05）。DN患者动脉化静脉血流量的增加不如非DN患者明显。这些结果表明，DN患者晚期阻塞的高发生率可能部分反映在鼻烟窝部位动脉化静脉血流量增加不足。
