腕部头静脉的解剖研究在动静脉内瘘成形术中的应用.pdf

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1、·510·中国中西医结合肾病杂志2o15年6月第l6卷第6期CJITWN．June2o15．V01．16。No．6腕部头静脉的解剖研究在动静脉内瘘成形术中的应用水童进东①谭德炎@田众一①史卫军①余波①(摘要]目的：探讨上肢腕部头静脉解剖学特点在动静脉内瘘成形术中的应用。方法：选择3O例慢性肾衰竭5期患者，术前彩超辅助下标记头静脉主干，以腕部头静脉手背支和头静脉拇指支汇合点为中心，将腕部头静脉分成腕部远心端头静脉段和腕部近心端头静脉段，测量各段静脉直径、静脉分支及瓣膜的数量、各段头静脉与桡动脉间距等指标，并通过术中

2、观察再次确认静脉的瓣膜及分支。结果：腕部远心端段头静脉直径明显小于腕部近心端段头静脉直径，两者相比较差异存在统计学意义(P<0．01)，腕部近心端段的头静脉瓣膜及静脉分支较远心端段少，两者相比较差异也存在统计学意义(P<0．01)，且腕部近心端段的头静脉与桡动脉间距离较腕部远心端头静脉近(P<0．05)。结论：上肢腕部远心端头静脉偏细小，且存在较多的分支及瓣膜，而腕部近心端头静脉有更大的直径以及较少的分支和瓣膜，更符合临床动静脉内瘘成形术的要求。[关键词]动静脉瘘血液透析头静脉ApplicationoftheCe

3、phalicVeinAnatomyoftheWristinArteriovenousFistulaAngioplastyTONGJindong，TANDeyan，TIANZhongyi，etalDepartmentofVascularSurgery，ShanghaiPudongHo~iml，FudanUnive~ityPudongMedicalCenter，Shanghai(201399)ABSTRACTObjective：Toinvestigatetheanatomiccharacteristicsofuppe

4、rlimbwristcephalicveininarteriovenousfistulaangioplastyandstentingin．Methods：30casesofchronicrenalinsuficiencyin5patients，preoperativecolorDopplerultrasoundas-sistedsubscriptheadvein，cephalicveintothewristdorsalbranchandtheheadveinthumbconfluencepointasthecen

5、ter，willheadintothewristwristveindistalofcephalicveinsegmentandwristproximalheadveinsegment，measuringsectionsveindiameter，branchveinandvalvenumber，eachsectionofthecephalicveinandradialarteryspacingindex，andonceagainconfirmedasabranchandvenousvalvebyintraopera

6、tiveobservation．Results：ThewristdistalsegmentofthecephalicveindiameterWassignificantlysmallerthanthewristproximalsegmentofthecephalicveindiameter，thecomparisonWassignificantlystatisticaldiference(P<0．01)，headofvenousandvenousbranchproximalsegmentofthewristisd

7、istalsegmentislittle，thecomparisonisalsoverysignifi—cantstatisticaldiference(P<0．01)，andthewristproximalsegmentofthecephalicveinandradialarteryinthewristbetweenthedistancedistalcephalicveinnear(P<0．05)．Conclusion：Upperlimbwristdistalcephalicveinpartialsmall，a

8、ndtherealemanybranchesandvalves，andwristproximalveinheadhasaleaterdiame~randfewerbranchesandvalve，moreinlinewiththeclinicalarteriovenousfistulaangioplastyrequirements．KEYWORDSArteriovenou