张彦选，曲青山，李明，蒋欣，房军，刘瑞勇，苗书斋郑州人民医院器官移植中心，河南郑州　450002

肾移植术中桡动脉与动静脉内瘘穿刺置管在有创血压监测中的应用比较

张彦选，曲青山，李明，蒋欣，房军，刘瑞勇，苗书斋
郑州人民医院器官移植中心，河南郑州450002

目的比较肾移植术中穿刺健侧桡动脉和动静脉内瘘行有创动脉压连续监测的应用效果，评价动静脉内瘘穿刺置管行有创血压的可行性。方法选择2014年6月—2015年12月在该科住院的82例肾移植患者术，其中采取桡动脉（A组）和动静脉内瘘穿刺置管（B组），对两组首次穿刺成功率、穿刺次数和时间、疼痛评分及并发症进行分析，并对临床效果进行评价。结果动静脉内瘘组穿刺成功率高、穿刺时间短、穿刺次数少、血管并发症少、疼痛评分低于桡动脉组，差异均有统计学意义。结论动静脉内瘘穿刺置管是一种穿刺成功率更高、安全且并发症较少的动脉穿刺置管的路径，值得在临床工作中推广。

肾移植；动静脉内瘘；有创血压监测；桡动脉；动脉穿刺置管

［Abstract］Objective To compare the puncture the contralateral radial artery in renal transplantation and arteriovenous fistula in line with the application effect of arterial pressure continuous monitoring，evaluation of arteriovenous fistula in line of the feasibility of the invasive blood pressure tube.Methods 82 cases of renal transplantation patients from June 2014 to December 2015 who take in radial artery（group A）and arteriovenous fistula（group B），tube on two groups of puncture success rate for the first time，number and time of the piercing pain score and complications were analyzed，and to evaluate the clinical effect.Results Arteriovenous fistula in the high success rate，short time of puncture and biopsy was less，less vascular complications，pain score lower than that of radial artery group，difference has statistical significance.Conclusion Arteriovenous internal fistula is a kind of tube after puncture success rate higher，safe and less complications of arterial puncture catheter path，is worth popularization in clinical work.

［Key words］Renal transplantation；Arteriovenous internal fistula；Invasive blood pressure monitoring；Radial artery；Arterial puncture catheter

肾移植手术时行有创动脉压监测目前常规穿刺桡动脉，但穿刺成功率低、穿刺时间长，延长了麻醉时间、加重了患者痛苦。肾衰竭患者前臂多有桡动脉--头静脉的动静脉内瘘存在，穿刺容易、成功率高；但目前国内外文献未见有经动静脉内瘘穿刺行动脉压监测的报告，选择该中心2014年6月—2015年12月有动静脉内瘘的肾移植手术患者82例，术中同时穿刺健侧桡动脉和动静脉内瘘行有创动脉压连续监测24 h，比较二者的应用效果。……