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Management of the immature autogenous arteriovenous fistula

机译：未成熟的自体动静脉瘘的处理

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摘要

A high-quality autogenous arteriovenous fistula provides the optimal access for hemodialysis. Following initial surgical construction of a fistula, the maturation process is driven by hemodynamic, cellular, and humoral factors that must result in increased blood flow, vessel dilation, and thickening of the vessel wall before the fistula can be successfully used for dialysis needle access. Different demands are placed on each fistula depending on the individual patient's hemodialysis requirements, which must be clearly understood to properly assess and treat the immature fistula. When spontaneous maturation fails to achieve a functional fistula, additional surgical or minimally invasive interventional procedures may be necessary to enhance the maturation process. Various techniques have been reported to achieve successful fistula maturation. The purpose of this article is to review the concepts of fistula maturation and the interventions that may be performed in cases where there is failure to mature spontaneously.
机译：高质量的自体动静脉瘘提供了血液透析的最佳途径。在对瘘管进行最初的外科手术构造之后，成熟过程是由血液动力学，细胞和体液因素驱动的，这些因素必须导致血流量增加，血管扩张和血管壁增厚，然后瘘管才能成功用于透析针的进入。根据个体患者的血液透析要求，对每个瘘管提出不同的要求，必须清楚地理解这些要求，以正确评估和治疗未成熟的瘘管。当自发成熟不能实现功能性瘘管时，可能需要进行其他外科手术或微创介入手术以增强成熟过程。已经报道了各种技术来实现成功的瘘管成熟。本文的目的是回顾瘘管成熟的概念以及在无法自发成熟的情况下可以采取的干预措施。

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