Lastnosti distalnih struktur po konstrukciji arteriovenske fistule kot žilnegapristopa za hemodializo : [magistrsko delo]
Bratina, Petra, 1982-
Background Arteriovenous fistula (AVF) is preferred and most commonly used vascular access for hemodialysis. An uncommon, but serious complication is hand ishemia distal to AVF. It presents with hand ...pain, cold skin, sensorimotoric disturbances and can even lead to finger necrosis and amputation. Early and proper recognition is essential to prevent permanent damage of nerves of the hand and necrosis of the fingers. The purpose of our prospective clinical study was to estimate the effect of construcrion of AV fistula on the properties of distal structures of the hand, using non-invasivemethods. We also tested the hypothesis that there is a significantdifference in skin temperature, saturation of hemoglobin with oxygen, grip strength and diameters of hand arteries in fistula hand as compared to control, non fistula hand. Patients and methods Our study included44 adult patients with end - stage renal disease in the chronic hemodialysis program. Patients were asked about subjective symptoms of hand ishemia and had physically examined both hands including AV fistula. Skin temperature, digital oxigenization and grip strength on fistula and non - fistula hand were measured. In 24 patients Doppler wave analysis of AV fistulaand diameters of arteries of both hands were examined. Results There was no statistically significant difference between fistula and non - fistula hand in skin temperature, pulse oximetry, dynamometry and diameters of radial and ulnar artery. The diameter of arcus palmaris was significantly larger on fistula hand comparing to control hand. Conclusions Our results showed that properties of distal structures in fistula hand do not significantly differ from those in non -fistula hand, therefore the constriction of AVF in our patients did not lead to any significant changes in distal hand perfusion.
Type of material - master's thesis
; adult, serious
Publication and manufacture - Ljubljana : [P. Bratina], 2007
GS II 0000713148 glavno skladišče
GS II 713148 glavno skladišče
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