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相关概念视频

Dialysis01:27

Dialysis

261
Renal failure occurs when the kidneys lose their ability to filter waste products from the blood effectively. It can be classified into two types: acute renal failure (ARF) and chronic renal failure (CRF).
Acute kidney injury develops suddenly and can be caused by pre-renal causes (e.g., hypovolemia, shock), intrinsic renal causes (e.g., acute tubular necrosis), or post-renal causes (e.g., urinary obstruction). In contrast, chronic renal failure progresses gradually over time and is often...
261

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耗尽透析接入的替代方案

Laura B Pride1, Edwyn J Assaf1, Lauren N West-Livingston1

  • 1Department of Surgery, Division of Vascular and Endovascular Surgery, Duke University Medical Center, Durham, NC.

Seminars in vascular surgery
|December 15, 2024
PubMed
概括

血管外科医生经常面临血液透析 (HD) 的进入失败. 当传统的接入途径失败时,替代性手术选择,如血液透析可靠的输出移植和下肢抽/移植是有效的,保留导管作为最后的手段.

科学领域:

  • 血管外科 血管外科
  • 腎臟病學 (nephrology) 是一種醫學.
  • 透析服务 透析服务 透析服务

背景情况:

  • 血液透析 (HD) 无法接入是末期病管理的一个重大挑战.
  • 增加患HD患者的寿命导致传统上肢通道的耗尽.
  • 静脉外流阻塞是HD访问失败的最常见原因.

研究的目的:

  • 在传统方法失败时,审查血液透析的替代手术接入选项.
  • 评估非传统的HD接入方法的安全性和有效性.
  • 为创建替代通道提供系统的方法,优先考虑选择,而不是目的地道导管.

主要方法:

  • 关于非传统的HD接入选项的回顾性研究的元分析.
  • 专注于对中静脉狭窄或闭塞的升级程度的访问策略.
  • 对血液透析数据的综述可靠的外流移植,下肢/移植以及股骨静脉转移.

主要成果:

  • 较小的研究表明,对血液透析可靠的输出移植,大腿静脉转移和下肢移植的安全性和有效性是可以接受的.
  • 与传统HD相比,许多替代性HD接入选项的长期通透性,成本和并发症数据相对较少.
  • 非传统的选择可以有效地利用中枢静脉狭窄或闭塞的增加.
关键词:
提供替代性透析服务.这是一个HERO移植.血液透析的访问权限

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结论:

  • 当传统访问失败时,建议采用系统方法来创建替代的高清访问.
  • 血液透析可靠的外流移植和下肢动脉静脉/移植是可行的替代方案.
  • 目的地道式透析导管应作为最后手段保留在HD接入中.