Sivanesan S, How T V, Bakran A
Department of Clinical Engineering, University of Liverpool, UK.
Nephrol Dial Transplant. 1998 Dec;13(12):3108-10. doi: 10.1093/ndt/13.12.3108.
The arteriovenous fistula is the most widely used means of enabling vascular access for chronic haemodialysis. When interest in vascular access was at its height, in the 1970s, a substantial amount of work was carried out on the physiology of arteriovenous fistulae and on the relationship between fistula flow and patency. One omission in the catalogue of studies was research into the distribution of flow in the fistula and the effects on surgical outcome.
To address this issue, 30 patients with end-to-side radiocephalic fistulae were studied. Flow measurements were made intraoperatively, and at various intervals postoperatively using colour-flow ultrasonography.
In 22 cases, the development of the fistula was monitored at regular intervals for periods of up to 27 months. In seven of the 30 fistulae, flow in the distal artery was antegrade, while in the remaining 23, distal artery flow was retrograde. The proportion of fistula flow supplied by the proximal and distal arteries varied considerably.
Despite the wide range of flow distributions in the fistulae studied, flow distribution did not appear to affect fistula maturation or long-term function.
动静脉内瘘是慢性血液透析中应用最广泛的血管通路方式。20世纪70年代，当人们对血管通路的关注达到顶峰时，针对动静脉内瘘的生理学以及内瘘血流量与通畅性之间的关系开展了大量研究。研究目录中的一个遗漏之处是对瘘管内血流分布及其对手术结果影响的研究。
为解决这一问题，对30例行端侧桡动脉-头静脉内瘘术的患者进行了研究。术中及术后不同时间间隔使用彩色多普勒超声测量血流量。
22例患者的内瘘发育情况定期监测长达27个月。30个内瘘中有7个，其远端动脉血流为顺行，其余23个内瘘的远端动脉血流为逆行。近端和远端动脉提供的内瘘血流量比例差异很大。
尽管所研究的内瘘血流分布范围广泛，但血流分布似乎并未影响内瘘成熟或长期功能。
