Shen G, Leng Y, Rong G
Department of Plastic Surgery, Nanjing Railway Transport Medical College, Jiangsu.
Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. 1997 Mar;11(2):121-3.
The formation of an arteriovenous fistual for dialysis by routine interrupted sutures anastomosing the vein and artery is difficult to perform and time-consuming. A new method, telescopic adhesive anastomosis was studied and applied in 10 hemodialysis patients, who were in need of an arteriovenous fistula. The external diameter of the vessels anastomosed was 2.40 +/- 0.20 mm (radial artery) or 2.40 +/- 0.35 mm (cephalic vein). After thorough debridement of the vascular ends, the arterial end was put in the venous lumen. In order to fix the telescopic vessels, two stitches were applied 180 degrees apart from each other and tied. Each stitch was inserted from vein (penetrating the whole wall) to artery (just through the adventitia and partial thickness of the media vasorum). The distance from the stitch to the edge of the vein was 0.5 mm, and that of the artery was approximated to the external diameter of the vessle. The medical adhesive was then applied for sealing the anastomotic adventitia. Ten seconds were given for the solidification of the adhesive. The patients were followed up for 8 months. The patency rate was 100%, and the rate of blood flow was more than 300 ml/min (measured by ultrasonography). It was shown that this method could be managed easily and quickly, and the so-formed fistula would fulfill the need of hemodialysis.
通过常规间断缝合使动静脉吻合以形成用于透析的动静脉内瘘操作困难且耗时。研究了一种新方法——套入式黏合吻合术，并将其应用于10例需要动静脉内瘘的血液透析患者。吻合血管的外径为2.40±0.20毫米（桡动脉）或2.40±0.35毫米（头静脉）。在对血管断端进行彻底清创后，将动脉端置入静脉腔内。为固定套入的血管，相距180度缝两针并打结。每针从静脉（穿透整个管壁）插入至动脉（仅穿过外膜和部分中膜厚度）。缝线距静脉边缘0.5毫米，距动脉边缘约为血管外径。然后应用医用黏合剂封闭吻合外膜。给予10秒钟使黏合剂固化。对患者随访8个月。通畅率为100%，血流速度超过300毫升/分钟（通过超声检查测量）。结果表明，该方法操作简便快捷，所形成的内瘘能够满足血液透析的需求。
