| Background and Purpose:hemodialysis is the main alternative treatment methodspatient for end-stage renal disease (ESRD) patients. Be able to establish and maintain a good hemodialysis access is the key to long-term and fully hemodialysis, and autologous arteriovenous fistula(AVF) is widely recognized as the best hemodialysis access. But the early postoperative patency rate of AVF is an important indicator to determine the success of the access. However, with causes of chronic renal insufficiency more and more complex, AVF dysfunction is increasingly diverse. This brought some difficulties to clinicians to repair early AVF dysfunction. The commonly surgical Repairing methods is re-establish after the removal of thrombus. But the vascular access is the lifeline of hemodialysis patients, reserve vascularized resource for patients as well as save the life of patients, and re-establish fistula inevitable waste the resources of the patient’s blood vessels. How to overcome difficulties, improved surgical methods or puncture techniques to protect patients with limited vascular resources and improve the success rate of AVF is a direction of researching. This paper analysis and discuss the methed of using artificial blood pool to repair early AVF dysfunction, summarize the surgical experiences as well as to explore that affect the success rate of surgery-related factors, and thus raise awareness for repairing AVF, protecting vascular resources, improve AVF patency rates after repairing.Methods:The data come from Urology of Dongzhimen affiliated Hospital of Beijing University of Traditional Chinese Medicine. from January2011to January2013, outpatients and inpatients of early Autogenous arteriovenous fistula dysfunction,screened65cases, according to the surgical records with medical records and other medical information, and all patients’fistula dysfunction time<12h, all patients with failed thrombolysis, requiring surgical intervention. Statistics patients’ gender, age, mean arterial pressure, fistula use of time, whether diabetes. Divided into two groups according to the choice of surgical approach. Analyzed and compared the repairing method of using artificial blood pool and of non-application of artificial blood pool success rate in different situations, and at the same time separate analysis of the correlation time of patients with diabetes mellitus and mean arterial blood pressure in patients with internal fistula. Using SPSS17.0statistical software for analyzing.Result:the comparability analysis:31cases of male patients and34cases of female patients with x2test, P>0.05, able to compare; analysis of age, the average age of the experimental group to55.72in the control group The average age of56.18, between the two groups more practical, independent t test, P>0.05, able to compare; analysis of patients with diabetes mellitus, the experimental group composition ratio is58%to42%, of control group diabetic nephropathy to non-diabetic nephropathy composition ratio is56%to44%, with x2test, P>0.05, able to compare; analysis of mean arterial pressure, the experimental group is124.03mmhg, the control group is118.47mmhg, with independent samples t-test, P>0.05, with a statistically significant difference between the two groups of patients between the mean arterial pressure comparable. Fistula dysfunction in patients with two surgical approach using experimental results:t-test was used for statistical comparison, the results suggest that:P<0.05, the results have a statistical difference in the use of time; application of artificial blood pool repair surgical group internal fistula with age, mean arterial pressure, gender, diabetes, and other factors using pearson correlation analysis, the results suggest that:the time with diabetic nephropathy P<0.05, the results have a statistical difference, age, mean arterial pressure, gender, and other factors and the use of time P>0.05, not statistically significant, using pearson correlation analysis the application of conventional repairing technique group of factors such as age, mean arterial pressure, gender, whether diabetes, the results suggest that:the using time and the mean arterial pressure correlation P<0.05, the results statistically learning differences, age, diabetes, gender and other factors, and the using time P>0.05, does not have a statistically significant difference.Conclusion:This study shows that using the application of artificial blood pool repair early dysfunction of arteriovenous fistula has higher success rate than the conventional one, while patients with diabetes and patients of mean arterial pressure affects both internal fistula using time. But the age, mean arterial pressure, gender, and other factors and the using time of using artificial blood pool group P>0.05, does not have a significant difference. And the age, diabetes, gender and other factors and the using time P>0.05, does not have a significant difference.These conclusions does not meet some reported1iterature, may be cause by shorter observation time or less number of samples. |
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