血液透析患者转位动静脉瘘与动静脉移植的比较:荟萃分析和系统综述。

IF 28.7 1区 医学 Q1 NEUROSCIENCES Nature Reviews Neuroscience Pub Date : 2024-03-01 Epub Date: 2022-06-16 DOI:10.1177/11297298221102875
Qian-Hui Tang, Han Yang, Jing Chen, Qiu-Ning Lin, Zhong Qin, Ming Hu, Xiao Qin
{"title":"血液透析患者转位动静脉瘘与动静脉移植的比较:荟萃分析和系统综述。","authors":"Qian-Hui Tang, Han Yang, Jing Chen, Qiu-Ning Lin, Zhong Qin, Ming Hu, Xiao Qin","doi":"10.1177/11297298221102875","DOIUrl":null,"url":null,"abstract":"<p><p>It is challenging for a surgeon to determine the appropriate vascular access for hemodialysis patients whose cephalic vein is usually inaccessible. The purpose of the study is to compare the complications and patency rates between transposed arteriovenous fistulas (tAVF) and arteriovenous graft (AVG) for the hemodialysis patients. Studies were recruited from PubMed, Cochrane library, EMBASE, the web of science databases, and reviewing reference lists of related studies from the inception dates to September 2, 2021. Statistical analyses were conducted using the statistical tool Review Manager version5.3 (Cochrane Collaboration, London, UK). <i>I</i><sup>2</sup> > 50% was defined as a high degree of heterogeneity, and then a random-effects model was used. Otherwise, the fixed-effects model was used. Odds ratio with its 95% confidence interval (95% CI) was used. Thirty-three trials (26 retrospective studies, four randomized controlled trials, two prospective trials, and one controlled-comparative study) with 6430 enrolled participants were identified in our analysis. The results showed that tAVF was accompanied with lower thrombosis rate (103/1184 (8.69%) vs 257/1367 (18.80%); <i>I</i><sup>2</sup> = 45%; 95% CI, 0.34 (0.26, 0.45)) and infection rate (43/2031 (2.12%) vs 180/2147 (8.38%); <i>I</i><sup>2</sup> = 0%; 95% CI, 0.20 (0.14, 0.30)) than arteriovenous graft. The significantly better primary patency rates, secondary patency rates, and primary assisted patency rates during follow-up were found in tAVF. However, the failure rate and the prevalence of hematoma were significantly lower in AVG group. No evidence showed the rate of overall mortality, steal syndrome, and aneurysm reduced in tAVF. Our results showed that tAVF is a promising vascular access technique for hemodialysis patients whose cephalic vein is inaccessible. Our data showed that tAVF has less thrombosis, infection risk, and better patency rates when compared with AVG. However, more attentions need to be paid to transposed arteriovenous fistulas maturation and hematoma.</p>","PeriodicalId":49142,"journal":{"name":"Nature Reviews Neuroscience","volume":"3 1","pages":"369-389"},"PeriodicalIF":28.7000,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Comparison between transposed arteriovenous fistulas and arteriovenous graft for the hemodialysis patients: A meta-analysis and systematic review.\",\"authors\":\"Qian-Hui Tang, Han Yang, Jing Chen, Qiu-Ning Lin, Zhong Qin, Ming Hu, Xiao Qin\",\"doi\":\"10.1177/11297298221102875\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><p>It is challenging for a surgeon to determine the appropriate vascular access for hemodialysis patients whose cephalic vein is usually inaccessible. The purpose of the study is to compare the complications and patency rates between transposed arteriovenous fistulas (tAVF) and arteriovenous graft (AVG) for the hemodialysis patients. Studies were recruited from PubMed, Cochrane library, EMBASE, the web of science databases, and reviewing reference lists of related studies from the inception dates to September 2, 2021. Statistical analyses were conducted using the statistical tool Review Manager version5.3 (Cochrane Collaboration, London, UK). <i>I</i><sup>2</sup> > 50% was defined as a high degree of heterogeneity, and then a random-effects model was used. Otherwise, the fixed-effects model was used. Odds ratio with its 95% confidence interval (95% CI) was used. Thirty-three trials (26 retrospective studies, four randomized controlled trials, two prospective trials, and one controlled-comparative study) with 6430 enrolled participants were identified in our analysis. The results showed that tAVF was accompanied with lower thrombosis rate (103/1184 (8.69%) vs 257/1367 (18.80%); <i>I</i><sup>2</sup> = 45%; 95% CI, 0.34 (0.26, 0.45)) and infection rate (43/2031 (2.12%) vs 180/2147 (8.38%); <i>I</i><sup>2</sup> = 0%; 95% CI, 0.20 (0.14, 0.30)) than arteriovenous graft. The significantly better primary patency rates, secondary patency rates, and primary assisted patency rates during follow-up were found in tAVF. However, the failure rate and the prevalence of hematoma were significantly lower in AVG group. No evidence showed the rate of overall mortality, steal syndrome, and aneurysm reduced in tAVF. Our results showed that tAVF is a promising vascular access technique for hemodialysis patients whose cephalic vein is inaccessible. Our data showed that tAVF has less thrombosis, infection risk, and better patency rates when compared with AVG. However, more attentions need to be paid to transposed arteriovenous fistulas maturation and hematoma.</p>\",\"PeriodicalId\":49142,\"journal\":{\"name\":\"Nature Reviews Neuroscience\",\"volume\":\"3 1\",\"pages\":\"369-389\"},\"PeriodicalIF\":28.7000,\"publicationDate\":\"2024-03-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Nature Reviews Neuroscience\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.1177/11297298221102875\",\"RegionNum\":1,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2022/6/16 0:00:00\",\"PubModel\":\"Epub\",\"JCR\":\"Q1\",\"JCRName\":\"NEUROSCIENCES\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Nature Reviews Neuroscience","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1177/11297298221102875","RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2022/6/16 0:00:00","PubModel":"Epub","JCR":"Q1","JCRName":"NEUROSCIENCES","Score":null,"Total":0}
引用次数: 0

摘要

血液透析患者的头静脉通常无法进入,对于外科医生来说,确定合适的血管通路是一项挑战。本研究旨在比较血液透析患者转位动静脉瘘(tAVF)和动静脉移植(AVG)的并发症和通畅率。研究从 PubMed、Cochrane 图书馆、EMBASE、web of science 数据库中收集,并查阅了自开始日期至 2021 年 9 月 2 日的相关研究参考文献列表。统计分析使用统计工具 Review Manager 5.3 版(Cochrane Collaboration,英国伦敦)进行。I2>50%定义为高度异质性,然后使用随机效应模型。否则采用固定效应模型。使用了带有 95% 置信区间 (95% CI) 的比值比。我们在分析中确定了 33 项试验(26 项回顾性研究、4 项随机对照试验、2 项前瞻性试验和 1 项对照比较研究),共 6430 名参与者。结果显示,与动静脉移植相比,tAVF 的血栓形成率(103/1184 (8.69%) vs 257/1367 (18.80%);I2 = 45%;95% CI, 0.34 (0.26, 0.45))和感染率(43/2031 (2.12%) vs 180/2147 (8.38%);I2 = 0%;95% CI, 0.20 (0.14, 0.30))更低。在随访中发现,tAVF的一次通畅率、二次通畅率和一次辅助通畅率均明显优于动静脉移植术。但 AVG 组的失败率和血肿发生率明显较低。没有证据显示 tAVF 的总死亡率、盗血综合征和动脉瘤发生率降低。我们的研究结果表明,对于头静脉无法进入的血液透析患者来说,tAVF 是一种很有前途的血管通路技术。我们的数据显示,与 AVG 相比,tAVF 的血栓形成和感染风险更低,通畅率更好。然而,转位动静脉瘘的成熟和血肿问题还需引起更多关注。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
查看原文
分享 分享
微信好友 朋友圈 QQ好友 复制链接
本刊更多论文
Comparison between transposed arteriovenous fistulas and arteriovenous graft for the hemodialysis patients: A meta-analysis and systematic review.

It is challenging for a surgeon to determine the appropriate vascular access for hemodialysis patients whose cephalic vein is usually inaccessible. The purpose of the study is to compare the complications and patency rates between transposed arteriovenous fistulas (tAVF) and arteriovenous graft (AVG) for the hemodialysis patients. Studies were recruited from PubMed, Cochrane library, EMBASE, the web of science databases, and reviewing reference lists of related studies from the inception dates to September 2, 2021. Statistical analyses were conducted using the statistical tool Review Manager version5.3 (Cochrane Collaboration, London, UK). I2 > 50% was defined as a high degree of heterogeneity, and then a random-effects model was used. Otherwise, the fixed-effects model was used. Odds ratio with its 95% confidence interval (95% CI) was used. Thirty-three trials (26 retrospective studies, four randomized controlled trials, two prospective trials, and one controlled-comparative study) with 6430 enrolled participants were identified in our analysis. The results showed that tAVF was accompanied with lower thrombosis rate (103/1184 (8.69%) vs 257/1367 (18.80%); I2 = 45%; 95% CI, 0.34 (0.26, 0.45)) and infection rate (43/2031 (2.12%) vs 180/2147 (8.38%); I2 = 0%; 95% CI, 0.20 (0.14, 0.30)) than arteriovenous graft. The significantly better primary patency rates, secondary patency rates, and primary assisted patency rates during follow-up were found in tAVF. However, the failure rate and the prevalence of hematoma were significantly lower in AVG group. No evidence showed the rate of overall mortality, steal syndrome, and aneurysm reduced in tAVF. Our results showed that tAVF is a promising vascular access technique for hemodialysis patients whose cephalic vein is inaccessible. Our data showed that tAVF has less thrombosis, infection risk, and better patency rates when compared with AVG. However, more attentions need to be paid to transposed arteriovenous fistulas maturation and hematoma.

求助全文
通过发布文献求助,成功后即可免费获取论文全文。 去求助
来源期刊
自引率
0.60%
发文量
104
期刊介绍: Nature Reviews Neuroscience is a multidisciplinary journal that covers various fields within neuroscience, aiming to offer a comprehensive understanding of the structure and function of the central nervous system. Advances in molecular, developmental, and cognitive neuroscience, facilitated by powerful experimental techniques and theoretical approaches, have made enduring neurobiological questions more accessible. Nature Reviews Neuroscience serves as a reliable and accessible resource, addressing the breadth and depth of modern neuroscience. It acts as an authoritative and engaging reference for scientists interested in all aspects of neuroscience.
期刊最新文献
Opening the gate to regeneration Fly connectome over the wire Neurobiology of attention-deficit hyperactivity disorder: historical challenges and emerging frontiers Social and emotional learning in the cerebellum Synaptic sleep pressure
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
现在去查看 取消
×
提示
确定
0
微信
客服QQ
Book学术公众号 扫码关注我们
反馈
×
意见反馈
请填写您的意见或建议
请填写您的手机或邮箱
已复制链接
已复制链接
快去分享给好友吧!
我知道了
×
扫码分享
扫码分享
Book学术官方微信
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术
文献互助 智能选刊 最新文献 互助须知 联系我们:info@booksci.cn
Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。
Copyright © 2023 Book学术 All rights reserved.
ghs 京公网安备 11010802042870号 京ICP备2023020795号-1