Journal of Chest Surgery

The Korean Society for Thoracic and Cardiovascular Surgery (대한심장혈관흉부외과학회)
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Clinical Analysis of Arteriovenous Fistula Using Perforating Vein on Antecubital Fossa

팔 오금에서 시행한 관통정맥을 이용한 동정맥루 조성술의 임상적 고찰

  • Choi, Kwang-Ho (Department of Thoracic and Cardiovascular Surgery, Pusan Paik Hospital, College of Medicine, Inje University) ;
  • Yoon, Young-Chul (Department of Thoracic and Cardiovascular Surgery, Pusan Paik Hospital, College of Medicine, Inje University) ;
  • Lee, Yang-Haeng (Department of Thoracic and Cardiovascular Surgery, Pusan Paik Hospital, College of Medicine, Inje University) ;
  • Cho, Kwang-Hyun (Department of Thoracic and Cardiovascular Surgery, Pusan Paik Hospital, College of Medicine, Inje University)
  • 최광호 (인제대학교 의과대학 부산백병원 흉부외과학교실) ;
  • 윤영철 (인제대학교 의과대학 부산백병원 흉부외과학교실) ;
  • 이양행 (인제대학교 의과대학 부산백병원 흉부외과학교실) ;
  • 조광현 (인제대학교 의과대학 부산백병원 흉부외과학교실)
  • Received : 2010.08.09
  • Accepted : 2010.10.07
  • Published : 2010.12.05
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Abstract

Background: It is very important to obtain vascular access that resists repeated punctures and maintains an adequate blood flow for performing hemodialysis in patients with ESRD. This study was designed to identify the risk factors that may influence the patency rate of arteriovenous fistula (AVF) using perforating vein on antecubital fossa. Material and Method: We analyzed 205 cases of AVF in 195 patients who underwent hemodialysis access surgery on antecubital fossa in our hospital from May 2006 to December 2009. Result: The patency rate of AVF from 6 months after surgery using perforating vein was 75.91%. The risk factors that influence the patency rate was age. There was no statistic difference between used vessels. Conclusion: The patency of the AVF using perforating vein on antecubital fossa was comparable. The condition of sex and location and presence or absence of diabetes and hypertension and other cardio-neurovascular disease did not make statistically significant effect on the AVF patency rate. The age was an independent risk factor for patency rate.

배경: 팔 오금에서 시행되는 위팔동맥과 자쪽 피부정맥이나 노쪽 피부정맥을 이용한 동정맥루 조성술 외에 관동정맥을 이용한 동정맥루 조성술을 시행하여 개통률 및 영향을 미치는 인자들을 조사, 분석하고자 한다. 대상 및 방법: 2006년 5월부터 2009년 12월까지 본원 흉부외과에서 팔오금에 동정맥루 조성술을 시행받은 192명 205예의 수술을 대상으로 후향적 조사를 실시하여 개통률 및 개통과의 연관성을 분석하였다. 결과: 관동정맥을 이용한 수술의 6개월, 1년, 2년 개통률은 75.91%, 60.79%, 37.80%으로 다른 혈관을 이용한 수술의 결과와 통계적으로 차이는 보이지 않았다. 여러 인자 중 연령에 따라 개통률에 차이를 보였다(p <0.001). 결론: 팔 오금에서 동정맥루 조성술이 필요한 환자에서는 관통정맥을 이용함으로써 노쪽 피부정맥과 자쪽 피부정맥을 사용할 수 있어 혈관의 접근 방법이 다양해지고 관통정맥의 해부학적 위치에 따라 술식의 어려움이 없어 수술 접근에 대한 추가적 대안이 될 수 있을 것이다.

Keywords

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