Kawecka A, Prajs J, Lipiński J, Białko M
Katedry i Kliniki Chirurgii Urazowej Akademii Medycznej w Gdańsku.
Wiad Lek. 1997;50 Suppl 1 Pt 2:60-4.
Treatment by means of repeated haemodialysis has been accepted as the basic method of renal substitution treatment in our country. Thrombosis has been found as the most frequent local complication in arterio-venous (A-V) fistulas. The purpose of this study has been to analyse the frequency of thrombosis in relation to the type of A-V fistula and occurrence of early thrombosis (within 24 postoperative hours). Studies have been based in 186 patients (31 children) in whom 545 A-V surgical procedures have been performed to create and maintain permanent vascular access for haemodialysis. The mean age of the patients was 37 years. Thrombosis has been detected in 41.5% of fistulas and has been found as the main cause of 49.4% secondary procedures. Most frequently they have been observed in A-V fistulas using PTFE prosthesis. Rare complications have been found in brachio-basilic and brachio-cephalic fistulas. Early thrombosis has been observed in 4.5% of A-V fistulas. The causes of early thrombosis and within 30 postoperative days have been discussed in detail. In these complications thrombectomy (60.5%) and thrombectomy combined with creating new anastomosis (31.9%) have been performed most frequently. It has concluded that the condition of anastomosed vessels is the most important factor influencing early thrombosis.
在我国，重复血液透析治疗已被公认为肾脏替代治疗的基本方法。血栓形成是动静脉（A-V）内瘘最常见的局部并发症。本研究的目的是分析血栓形成的频率与A-V内瘘类型以及早期血栓形成（术后24小时内）发生率之间的关系。研究对象为186例患者（31例儿童），共进行了545例A-V外科手术，以建立和维持用于血液透析的永久性血管通路。患者的平均年龄为37岁。在41.5%的内瘘中检测到血栓形成，且血栓形成是49.4%二次手术的主要原因。血栓形成最常出现在使用聚四氟乙烯（PTFE）人工血管的A-V内瘘中。在肱动脉-贵要静脉和肱动脉-头臂静脉内瘘中发现的并发症较少。4.5%的A-V内瘘出现早期血栓形成。详细讨论了术后30天内早期血栓形成的原因。在这些并发症中，最常进行的是血栓切除术（60.5%）以及血栓切除术联合建立新的吻合口（31.9%）。研究得出结论，吻合血管的状况是影响早期血栓形成的最重要因素。
