李凤楼, 焦自钊, 付海霞. 应用No-touch技术分离静脉构建维持性血液透析患者自体动静脉内瘘[J]. 临床肾脏病杂志, 2020, 20(2): 165-170. DOI: 10.3969/j.issn.1671-2390.2020.02.015
    引用本文: 李凤楼, 焦自钊, 付海霞. 应用No-touch技术分离静脉构建维持性血液透析患者自体动静脉内瘘[J]. 临床肾脏病杂志, 2020, 20(2): 165-170. DOI: 10.3969/j.issn.1671-2390.2020.02.015
    LI Feng-lou, JIAO Zi-zhao, FU Hai-xia. Applying theno-touch technique to venous dissection for the construction of the autogenous arteriovenous fistula in patients with maintenance hemodialysis[J]. Journal of Clinical Nephrology, 2020, 20(2): 165-170. DOI: 10.3969/j.issn.1671-2390.2020.02.015
    Citation: LI Feng-lou, JIAO Zi-zhao, FU Hai-xia. Applying theno-touch technique to venous dissection for the construction of the autogenous arteriovenous fistula in patients with maintenance hemodialysis[J]. Journal of Clinical Nephrology, 2020, 20(2): 165-170. DOI: 10.3969/j.issn.1671-2390.2020.02.015

    应用No-touch技术分离静脉构建维持性血液透析患者自体动静脉内瘘

    Applying theno-touch technique to venous dissection for the construction of the autogenous arteriovenous fistula in patients with maintenance hemodialysis

    • 摘要: 研究发现,在维持性血液透析(maintenance hemodialysis,MHD)患者自体动静脉内瘘(autogenous arteriovenous fistula,AVF)的构建过程中,静脉分离所造成的血管损伤可以通过激活血管外膜成纤维细胞、启动血管外膜炎症反应及损伤静脉滋养血管等导致AVF静脉血管内膜增生与血管狭窄等病变,进而引起AVF功能障碍。Souza等在利用大隐静脉进行冠状动脉旁路手术时,提出了静脉分离的No-touch技术,比较静脉分离的常规技术,其能够减轻静脉分离过程所造成的血管损伤,并提高术后移植静脉的通畅率。近年来,静脉分离的No-touch技术亦开始应用于MHD患者AVF构建过程中的静脉分离,为提高AVF术后通畅率提供了新的手术方法。本文将就应用该技术分离静脉构建AVF能够提高AVF术后通畅率的机制作一综述。

       

      Abstract: Studies have found that, the vascular injury caused by venous dissection during the construction of the autogenous arteriovenous fistula (AVF) in patients with maintenance hemodialysis (MHD) canresulted in venous intimal hyperplasia and stenosis of the AVF, by activating perivascular fibroblasts, initiating the inflammatory response of the perivascular membrane and damaging the venous vasa vasorum, so as to lead to the dysfunction of the AVF. When applying the saphenous vein tothe coronary artery bypass surgery (CABG), Souza et alproposed the no-touch technique (NTT)for vein dissection. Comparing with the conventional technique (CT) for vein dissection, NTT can reduce the vascular injury caused by the process of vein dissection and improve the postoperative patency rate of the vein graft. In recent years, NTT has been applied to venous dissection for the construction of the AVF in MHD patients, thus to provide a novel surgical method for improving the postoperative patency rate of the AVF. This article will reviews the mechanism how NTT for venous dissection and construction of AVF canimprove the postoperative patency rate of the AVF.

       

    /

    返回文章
    返回