自体动静脉内瘘成形术中三种不同血管缝合方式的临床研究

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Abstract Objective To improve the success rate of arteriovenous fistula operation by studying the clinical effect of three different vascular suturation techniques: continuous suture,continuous-discontinuous suture and discontinuous suture. Methods A total of 98 patients that underwent autogenous arteriovenous fistula operation in Nanjing Central Hospital from September 2015 to May 2017 were selected. In the same operation condition, they were randomly divided into three groups according to different vascular suturation technique: continuous suture group (32 cases), continuous-discontinuous suture group (33 cases) and discontinuous suture group (33 cases). Then, the one-time success rate of operation, the fistula patency rate postoperative 24 hours, 3 months, 6 months, the diameter of anatomosis and the blood flow change of fistula postoperative 1 month, 3 months, 6 months were compared among the three groups, and statistical analysis was made to analyze the data. Results The one-time success rate of operation among the three groups had statistically significant difference (P ＜ 0.05). The one-time success rate of continuous-discontinuous suture group was higher than those of continuous suture group and discontinuous suture group that had statistically significant differences (P ＜ 0.05). The fistula patency rate in the continuous-discontinuous suture group was higher than the continuous suture group postoperative 3 months and 6 months (P ＜ 0.05). The fistula patency rate in the discontinuous suture group was higher than the continuous suture group postoperative 24 hours, 3 months and 6 months (P ＜ 0.05). The fistula patency rate had difference among the three groups (P < 0.05). The diameter of anatomosis in the continuous-discontinuous suture group and discontinuous suture group were longer than the continuous suture group postoperative 1, 3 and 6 months (P ＜ 0.01); the diameter of anatomosis in the discontinuous suture group was longer than the continuous-discontinuous suture group postoperative 1 month and 6 months (P ＜ 0.05); the diameter of anatomosis among the three groups had high statistically significant difference (P < 0.01). The blood flow of fistula in the continuous-discontinuous suture group was higher than the continuous suture group postoperative 1, 3 and 6 months (P ＜ 0.05); the blood flow of fistula in discontinuous suture group was higher than the other two groups postoperative 1 month and 6 months (P ＜ 0.05); the blood flow of fistula among the three groups postoperative 1, 3, 6 months had statistically significant difference (P < 0.01). Conclusion The continuous-discontinuous suture is a good suturation manner that combines the advantages of continuous suture and discontinuous suture, and it is a good technique for vascular anastomosis in internal arteriovenous fistula.

Key words： Internal Arteriovenous fistula Suturation manner Continuous suture Discontinuous suture Continuous-discontinuous suture

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	OUYANG Bin ZHANG Haifeng PAN Ningfeng ZHAO Feng YANG Dengyuan XING Chuanming

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OUYANG Bin ZHANG Haifeng PAN Ningfeng ZHAO Feng YANG Dengyuan XING Chuanming. Clinical study of three vascular suturation techniques in autogenous arteriovenous fistula operation[J]. 中国医药导报, 2018, 15(25): 83-86,95.

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http://www.yiyaodaobao.com.cn/EN/ OR http://www.yiyaodaobao.com.cn/EN/Y2018/V15/I25/83

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