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A Murine Model of Hemodialysis Access-Related Hand Dysfunction
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在儿童和青少年中创造血液透析的自生性获取
Lucas Phi1, Hannah Jayroe2, Nasir Mushtaq3
1Division of Vascular Surgery, Department of Surgery, University of Oklahoma School of Community Medicine, Tulsa, OK.
Journal of vascular surgery
|November 12, 2023
概括
动脉静脉 (AVF) 是儿童末期病 (ESRD) 患者的成功血管接入策略. 靠近径向动脉的AVF提供安全和功能性的选择,当远端囊是不可行的,在36个月达到85%的累积通透率.
科学领域:
- 血管外科 血管外科
- 儿科脏病学 儿科脏病学
- 脏替代疗法治疗 脏替代疗法
背景情况:
- 儿科和青少年群体的末期病 (ESRD) 不常见.
- 关于儿科ESRD血管接入的发表报告是有限的.
- 自生动脉静脉 (AVF) 是血液透析的首选血管接入方式.
研究的目的:
- 分析了在儿科和青少年患者中创建AVF的10年经验.
- 审查在年轻患者中建立功能性自身血管接入的策略.
- 在这个群体中报告AVF创建的结果.
主要方法:
- 对19岁及10岁以上的血管接入患者的回顾性审查.
- 手术前的血管超声波绘图由外科医生和体检.
- 优先考虑远端前臂放射性AVF,其次是近端辐射动脉输入AVF.
- 对人口统计数据,输入动脉,静脉输出目标和手术技术 (转位/转位) 的分析.
- 卡普兰-梅尔对初级和累积通透率的分析.
主要成果:
- 在35名患者 (6-19岁) 中创建了37个AVF;没有使用移植.
- 在25名患者中使用了近端辐射动脉的输入;在7名患者中使用了手臂动脉.
- 11名患者需要移植,一名患者需要静脉转位.
- 没有出现手缺血病例;两名患者后来需要为高流量带带.
- 五个AVF失败了,在大多数情况下成功创建了新的AVF或替代管理.
- 初级通透率在12个月时为75%,在36个月时为51%.
- 12,24和36个月的累计通透率为85%.
结论:
- 动脉静脉囊的创建是儿童和青少年血液透析患者的成功血管接入策略.
- 当远程AVF无法实现时,近端辐射动脉AVF提供了一个安全和功能性的替代方案.
- 高累积穿透率支持AVF作为该人群中持久的血管接入选项.
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