PDF(Pubmed)
Abstract：
UNASSIGNED: The preferred vascular access for hemodialysis is a native arteriovenous fistula (AVF) because it offers the best results in the short and long terms, lower morbidity and mortality, and has additional advantages in relation to central venous catheters or arteriovenous grafts. However, obesity can present an additional challenge because of the barrier of subcutaneous cellular tissue covering the surface of the vein to be punctured.
UNASSIGNED: The authors review their experience with excision of subcutaneous tissue (lipectomy) overlying upper arm cephalic vein arteriovenous fistulas in obese patients.
UNASSIGNED: Consecutive vascular access patients undergoing lipectomy for cannulation with difficult access because of vein depth were reviewed. Cephalic vein depth was measured by ultrasound in all cases.
UNASSIGNED: Twenty-two patients were reviewed (15 men and 7 women), with a mean body mass index of 34.0 kg/m2 (range: 28-40 kg/m2). Mean age was 58.4 years. The mean preoperative vein depth of 7.9 mm (range: 7.0-10.0 mm) was reduced to 4.7 mm (range: 3.0-6.0 mm) (P 0.01). The mean follow-up period for patients was 13.2 months. Four patients were lost to follow-up and four died during the period due to causes unrelated to vascular access.
UNASSIGNED: Obesity should not be a limiting factor to creation of a native AVF, since lipectomy is a relatively simple option for superficialization, enabling functioning native and deep arteriovenous fistulas in obese patients.
UNASSIGNED: The authors review their experience with excision of subcutaneous tissue (lipectomy) overlying upper arm cephalic vein arteriovenous fistulas in obese patients.
UNASSIGNED: Consecutive vascular access patients undergoing lipectomy for cannulation with difficult access because of vein depth were reviewed. Cephalic vein depth was measured by ultrasound in all cases.
UNASSIGNED: Twenty-two patients were reviewed (15 men and 7 women), with a mean body mass index of 34.0 kg/m2 (range: 28-40 kg/m2). Mean age was 58.4 years. The mean preoperative vein depth of 7.9 mm (range: 7.0-10.0 mm) was reduced to 4.7 mm (range: 3.0-6.0 mm) (P 0.01). The mean follow-up period for patients was 13.2 months. Four patients were lost to follow-up and four died during the period due to causes unrelated to vascular access.
UNASSIGNED: Obesity should not be a limiting factor to creation of a native AVF, since lipectomy is a relatively simple option for superficialization, enabling functioning native and deep arteriovenous fistulas in obese patients.
摘要：
■血液透析首选的血管通路是天然动静脉瘘（AVF），因为它在短期和长期中均可提供最佳结果，较低的发病率和死亡率，并且在中心静脉导管或动静脉移植物方面具有额外的优势。然而,由于皮下细胞组织的屏障覆盖了要被穿刺的静脉表面,肥胖可能带来额外的挑战.
■作者回顾了他们在肥胖患者上臂头静脉动静脉瘘上的皮下组织切除（脂肪切除术）的经验。
■回顾了因静脉深度而难以进入导管的连续血管通路患者行脂肪切除术。在所有情况下，均通过超声测量头静脉深度。
■检查了22例患者（15例男性和7例女性），平均体重指数为34.0kg/m2（范围：28-40kg/m2）。平均年龄为58.4岁。术前平均静脉深度7.9mm（范围：7.0-10.0mm）减少到4.7mm（范围：3.0-6.0mm）（P0.01）。患者的平均随访期为13.2个月。在此期间，由于与血管通路无关的原因，四名患者失去了随访，四名死亡。
■肥胖不应该成为本地AVF创建的限制因素，由于脂肪切除术是一种相对简单的表面化选择，使肥胖患者的天然和深动静脉瘘发挥作用。
■作者回顾了他们在肥胖患者上臂头静脉动静脉瘘上的皮下组织切除（脂肪切除术）的经验。
■回顾了因静脉深度而难以进入导管的连续血管通路患者行脂肪切除术。在所有情况下，均通过超声测量头静脉深度。
■检查了22例患者（15例男性和7例女性），平均体重指数为34.0kg/m2（范围：28-40kg/m2）。平均年龄为58.4岁。术前平均静脉深度7.9mm（范围：7.0-10.0mm）减少到4.7mm（范围：3.0-6.0mm）（P0.01）。患者的平均随访期为13.2个月。在此期间，由于与血管通路无关的原因，四名患者失去了随访，四名死亡。
■肥胖不应该成为本地AVF创建的限制因素，由于脂肪切除术是一种相对简单的表面化选择，使肥胖患者的天然和深动静脉瘘发挥作用。
