前臂与上臂动脉静脉囊的纵向结果
Mohit K Manchella1, Abena Appah-Sampong2, Mengyuan Ruan1
1Division of Vascular and Endovascular Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, MA.
Journal of vascular surgery
|June 9, 2025
概括
前臂动脉静脉 (AVFs) 与上臂AVF表现出类似的长期血液透析成功,但并发症较少. 然而,结果取决于中心.
科学领域:
- 腎臟病學 (nephrology) 是一種醫學專業.
- 血管外科 血管外科
- 透析的访问 透析的访问
背景情况:
- 国家指导方针偏好前臂动脉静脉 (AVFs) 进行血液透析而不是上臂AVFs.
- 前臂和上臂AVF之间的比较纵向结果仍未得到充分研究.
研究的目的:
- 评估和比较前臂与上臂AVF在晚期病患者的纵向结果.
主要方法:
- 一项队列研究分析了三个前性研究 (2014-2019) 中1516名患者的数据.
- 结果包括3年初级,初级辅助和二级通透率,成功使用AVF以及与访问相关的手力缺血症 (ARHI) 干预措施.
- 统计分析使用了Cox和后勤回归,分组分析按机构体积分层.
主要成果:
- 在前臂和上臂AVF之间,在3年穿透性或12个月成功使用AVF方面没有发现显著差异.
- 前臂AVF显示,与接入相关的手臂缺血症 (ARHI) 干预的风险明显降低.
- 与上臂AVF相比,在低体积中心创建的前臂AVF显示出较差的初级辅助和二级通透率和12个月后较低的AVF使用率.
结论:
- 前臂AVF提供与上臂AVF具有较低ARHI率的长期通透性和可用性相比较的长期通透性和可用性.
- 机构体积显著影响前臂AVF结果,在体积较小的中心观察到较差的结果.
- 系统层面的策略是必要的,以提高前臂AVF对末期病患者的结果.
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