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血液透析的动脉静脉接入:一个审查
Charmaine E Lok1,2, Thomas S Huber3, Ani Orchanian-Cheff4
1Department of Medicine, Division of Nephrology, University Health Network, Toronto, Ontario, Canada.
JAMA
|March 18, 2024
概括
创建和维持血液透析血管通道,如动脉静脉或移植,对于功能衰竭患者至关重要. 及早规划和及时处理并发症可以确保透析和患者的最佳结果.
科学领域:
- 肝脏病学
- 血管外科
- 内部医学
背景情况:
- 血液透析需要可靠的血管通道,主要是自身动脉静脉或非自身动脉静脉移植.
- 本综述侧重于构建和维护血液透析动脉静脉通道的关键方面.
研究的目的:
- 审查血液透析动脉静脉通道的构建和维护中的关键问题.
- 强调个性化策略和及时转诊对于透析的重要.
主要方法:
- 关于血液透析血管接入的当前文献和临床实践的审查.
- 对动脉静脉接入的并发症,成熟时间和管理策略的分析.
主要成果:
- 自生需要3-6个月才能成熟;移植需要2-4周,早期化移植可以在24-72小时内使用.
- 内体增生是导致狭窄和成熟失败的关键病变 (33% - 62%).
- 并发症包括狭窄,成熟失败,盗窃综合征 (1% - 8%),感染和出血.
结论:
- 对于功能衰竭患者来说,选择,创建和维护动脉静脉通道至关重要.
- 一般医生在保护访问,识别并发症和促进及时转诊方面至关重要.
- 个性化患者策略 (PLAN) 和主动管理对于成功的置换疗法至关重要.
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