Infection of hemodialysis arteriovenous grafts
Infection of hemodialysis arteriovenous grafts
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DOI：
10.1177/112972981001100213
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发表时间：
2010-04-01
影响因子：
1.9
通讯作者：
Patel, Neil
中科院分区：
文献类型：
--
作者：
Akoh, Jacob A.;Patel, Neil
目的：人工动静脉移植物(AVG)存在严重的感染并发症。本研究旨在探讨人工AVG术后感染并发症，并复习相关文献。方法：对2000年1月至2007年12月间植入的所有人工AVG进行研究。结果：58例患者共置入84枚AVG，分析年龄、性别、植入日期、AVG适应证、植入部位、移植物相关感染日期、移植肾治疗及转归。大腿AVG占55%，上臂AVG占39%。13例(17.3%)AVG合并一次或多次感染。植入物的感染率(50%)与聚四氟乙烯(12%)的感染率差异有统计学意义--Yates‘s x(2)=6.164；df=1；p=0.013。股部移植物的感染率(9/37)高于其他部位(4/34)，但差异无统计学意义(Yates‘s x(2)=1.123；df=1；p=0.289)。仅有1例死亡与AVG感染直接相关。结论：AVG感染性并发症需要及时的手术或放射治疗，以挽救生命或获得通路。完全切除受感染移植物的需要有时会被为血液透析提供血管通路的迫切需要所抵消，而患者的血管通路选择有限。
Purpose: Prosthetic arteriovenous grafts (AVG) are bedeviled by significant infectious complications. This study was to determine the infectious complications of prosthetic AVG and review the relevant literature.Methods: All prosthetic AVG inserted between January 2000 to December 2007 were studied. Data on age, sex, date of graft insertion, indication for AVG, site of graft insertion, date of graft related infection, treatment and outcome for graft and patients were analyzed.Results: There were 84 AVG inserted into 58 patients. Thigh AVG accounted for 55% of cases whereas upper arm AVG was inserted in 39%. Thirteen (17.3%) AVG were associated with one or more episodes of infection. The infection rate for SynerGraft (50%) was statistically significantly different from that of PTFE (12%) - Yates' x(2)=6.164; df=1; p=0.013. The rate of infection was higher for thigh grafts (9/37) compared to other sites (4/34), but the difference was not statistically significant (Yates' x(2)=1.123; df=1; p=0.289). Only one death was directly related to AVG infection in this series.Conclusion: Infectious complications of AVG require prompt surgical or radiological intervention to save life or access. The need to excise an infected graft completely is sometimes counterbalanced by the compelling need to provide vascular access for hemodialysis in a patient with limited access options.