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find Keyword "动静脉内瘘" 18 results
  • 临床路径在自体动静脉内瘘患者健康教育中的应用

    目的探讨临床路径应用于自体动静脉内瘘患者健康教育的可行性和实施效果。 方法对2012年6月-12月40例行自体动静脉内瘘术患者,随机分为观察组和对照组各20例,观察组采用临床路径进行健康教育,对照组则采用常规方式进行健康教育,比较两组患者对健康教育的掌握程度及满意度。 结果两组患者健康教育知识掌握率分别为100%和70%;满意度分别为95%和85%,两组比较差异均有统计学意义(P<0.05)。 结论应用临床路径管理后患者可更好的掌握健康教育知识,有效的保护动静脉内瘘,其满意度大幅提高。

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  • 覆膜支架治疗医源性股动静脉内瘘的临床疗效分析(附9例报道)

    目的总结股动静脉内瘘的发生原因及处理策略,为临床诊治此类疾病提供诊疗经验。方法回顾性收集2013年9月至2023年5月期间中国人民解放军联勤保障部队第九〇〇医院普通外科收治的9例股动静脉内瘘患者的临床资料,分析其发生原因、手术方式及治疗效果。结果9例患者的动静脉内瘘形成均因血管穿刺所致,包括5例房颤患者行射频导管消融术、3例脑梗死患者行取栓术以及1例尿毒症患者行临时血液透析管置入术;9例患者均行覆膜支架隔绝术,经手术治疗均治愈,技术成功率为100%。手术时间60~150 min,中位数为90 min;术中出血量10~50 mL,中位数为20 mL;术后住院时间为8~12 d,中位数为10 d。所有患者术后均未闻及血管杂音、患肢肿胀消退。9例患者均获得随访,随访时间3~24个月,中位随访时间为16个月。随访期间均未出现心脑血管疾病等并发症,超声复查血管通畅无复发迹象。结论因创伤小、可远程接近损伤部位、术后感染风险低、住院时间短、失血少等优势,介入手术可应用于临床治疗股动静脉内瘘患者。

    Release date:2024-03-23 11:23 Export PDF Favorites Scan
  • 彩色多普勒超声在透析患者动静脉内瘘并发症中的应用

    目的 探讨彩色多普勒超声在透析患者动静脉内瘘并发症中的应用价值。 方法 2009年1月-2012年4月应用彩色多普勒超声检测129例透析患者动静脉内瘘瘘口、桡动脉、头静脉的解剖及血流动力学状况。 结果 129例透析患者动静脉内瘘中103例动静脉内瘘通畅,12例血栓形成,7例狭窄,4例静脉瘤样扩张,2例血肿,1例局部感染。 结论 彩色多普勒超声是监测透析患者动静脉内瘘血管通路的无创、简便、快速、有效的检测方法,能明确诊断动静脉内瘘并发症,还能快速诊断其低血流量原因,从而为临床及时治疗提供科学依据。

    Release date:2021-06-23 07:35 Export PDF Favorites Scan
  • 动静脉内瘘异常重构的手术干预一例

    Release date:2020-08-25 09:57 Export PDF Favorites Scan
  • Exploration of a new model for integrated medical and nursing follow-up management of vascular access for patients with hemodialysis during hospitalization and outpatient period

    At present, the whole lifecycle management of vascular access for hemodialysis in China is still in its early stages. Faced with a large group of chronic kidney disease patients, hospitals at all levels lack systematic and continuous nursing management models. To address the issue of lacking continuous and effective nursing management of vascular access for dialysis during the period from hospitalization for autologous arteriovenous fistula surgery to outpatient maintenance hemodialysis treatment, this article introduces the background, specific implementation methods, and preliminary results of the new model of integrated medical and nursing follow-up management of vascular access for patients with hemodialysis during hospitalization and outpatient period constructed by the Wenjiang Hemodialysis Center of West China Hospital, Sichuan University. The purpose is to explore a new model for continuous and effective management of vascular access for hemodialysis patients.

    Release date:2024-04-25 02:18 Export PDF Favorites Scan
  • MID-TERM RESULTS OF ARTERIOVENOUS AXILLARY LOOP GRAFT ON CHEST FOR ESTABLISHING HEMODIALYSIS ACCESS

    ObjectiveTo explore the role of arteriovenous axillary loop graft (AVALG) on chest for establishing hemodialysis access in patients with chronic renal failure. MethodsA retrospective analysis was made on the clinical data of 12 patients with chronic renal failure who underwent an AVALG on chest for hemodialysis access between December 2010 and May 2014. There were 2 males and 10 females with an average age of 65.25 years (range, 46-75 years). The main causes were chronic glomerulonephritis in 6 cases, diabetic nephropathy in 4 cases, and both kidney resection because of urinary tract tumors in 2 cases. The disease duration was 2-12 years (mean, 6 years). The 12 patients all underwent 5-14 times (mean, 7 times) failed prior vascular accesses [arteriovenous fistula (AVF)and arteriovenous graft (AVG)] leading to exhaustion of venous access sites on the upper extremities. ResultsThe AVALG on chest were functionally useful for hemodialysis access, 2-3 times per week, and the blood flow was 250-350 mL/minute; the average time for the first dialysis was 48 days (range, 42-93 days). All patients were followed up 12-54 months (mean, 20.92 months). There was no death during perioperative period. The primary patency rates at 6 and 12 months were 91.7% and 83.3% respectively, and the secondary patency rates at 6 and 12 months were both 100%. After operation, infection (1 case), thrombosis (2 cases), bleeding (2 cases), and swollen (1 case) occurred, which were all cured after corresponding treatment. ConclusionAVALG on chest is a supplementary option for chronic renal failure patients with inadequate upper extremity venous access sites after repeat occlusion.

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  • 血液透析患者动静脉内瘘并发症的护理对策

    目的:总结分析维持性血液透析患者动静脉内瘘使用过程中的主要并发症,探讨积极有效的护理对策,延长内瘘的使用寿命。方法:回顾156例维持性血液透析患者资料,分析其动静脉内瘘使用过程中的主要并发症及其相应的护理对策。结果:瘘并发症按发生率高低依次为出血、血流量不足、假性动脉瘤和血栓形成,无一例感染。结论:出血及血流量不足是动静脉内瘘的主要并发症,及时有效的护理措施可预防减少并发症的发生,延长内瘘的使用寿命。

    Release date:2016-09-08 09:56 Export PDF Favorites Scan
  • The interventional treatment of venous hypertension associated with autogenous arteriovenous fistula

    Objective To investigate the clinical effect and safety of balloon angioplasty (BAP) for patients with venous hypertension associated with autogenous arteriovenous fistula (AVF). Methods Thirty-three patients with venous hypertension associated with AVF were hospitalized between August 2012 and August 2014 in the Department of Nephrology, West China Hospital of Sichuan University. All of the patients received BAP therapy. The clinical characteristics and therapeutic effects were comparatively summarized before and after operation. Results Venous hypertension in all the 33 patients was caused by central venous stenosis or occlusion. Among them, there were 13 cases of stenosis on the site where the left innominate vein crossed the aorta, 10 cases of stenosis at the junction of the left innominate vein and superior vena cava, 4 cases of stenosis at the junction of the left subclavian vein and the innominate vein, 3 cases of right innominate vein stenosis, and 3 cases of innominate vein occlusion. The lesions were most common in the innominate vein. Innominate vein stenosis or occlusion occurred in 19 cases (57.6%), and stenosis at the junction of innominate vein and the superior vena cava or subclavian vein occurred in 14 cases (42.4%). Of the 33 patients, one patient with complete occlusion of the innominate vein did not receive BAP treatment because guide wire could not pass through the occlusion site. The other 32 patients underwent BAP treatment, among whom 30 (93.8%) were successful, and 2 (6.2%) failed. No obvious complications occurred. One day after BAP treatment, patients’ symptoms were significantly relieved. One to seven days later, swelling of the hands, pain, and other symptoms were relieved. In the 30 patients who underwent the treatment successfully, 29 were followed up for 3 to 24 months. Among them, 21 (72.4%) maintained clinical remission and the AVFs were functional, 6 patients (20.7%) got a restenosis later, and 2 patients died. Conclusions BAP is effective and safe for venous hypertension associated with AVF. However, the follow-up of patients has displayed the possible risk of restenosis in long-term outcomes.

    Release date:2017-02-22 03:47 Export PDF Favorites Scan
  • 内瘘切口脂肪液化致内瘘破裂出血、瘘闭一例

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  • Long-term results of chest wall arteriovenous graft for establishing hemodialysis access

    ObjectiveTo explore the role of chest wall arteriovenous graft (CWAVG) for establishing hemodialysis access in patients with end-stage renal disease.MethodsA retrospective analysis was made on the clinical data of 12 patients with end-stage renal disease who underwent CWAVG for establishing hemodialysis access between January 2014 and June 2015. There were 3 males and 9 females with an average age of 63.6 years (range, 54-82 years). The renal disease causes were chronic glomerulonephritis in 2 cases, hypertensive renal damage in 4 cases, diabetic nephropathy in 1 case, both kidney resection because of urinary tract tumors in 3 cases, and causes unknown in 2 cases. Hemodialysis time ranged from 1 to 144 months, with an average of 38.4 months. The 12 patients all underwent 1-14 times (mean, 4.2 times) anterior pathway failure in CWAVG, all of which were caused by repeated occlusion of dialysis pathway or poor vascular condition of upper extremity, resulting in the exhaustion of vascular pathway in upper extremity.ResultsAll patients were followed up 30-48 months (mean, 35.4 months). Two patients died, including 1 case of digestive tract hemorrhage, 1 case of heart failure. The other 10 CWAVGs were functionally useful for hemodialysis access about 6 weeks after operations. The primary patency rates at 6, 12, 18, 24, and 30 months were 83.3%, 75.0%, 33.3%, 33.3%, and 16.7%, respectively, and the cumulative patency rates at 6, 12, 18, 24, and 30 months were 83.3%, 75.0%, 50.0%, 33.3%, and 16.7%, respectively. Among 8 cases of CWAVG dysfunction, 6 cases had thrombosis, 1 case had seroma, and 1 case had vertebral artery stealing. Among them, 4 patients underwent hemodialysis using tunneled-cuffed catheter, 3 patients using fistula or graft on other limbs, and 1 patient was not treated with hemodialysis.ConclusionAlthough the long-term patency rate of CWAVG is yet to be further increased by improvement of treatment strategies, but it is still a supplementary option for end-stage renal disease patients with inadequate upper extremity venous access sites.

    Release date:2019-01-25 09:40 Export PDF Favorites Scan
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