Complicaciones de accesos vasculares con resolución quirúrgica en la Unidad de Hemodiálisis del Hospital Teodoro Maldonado Carbo año 2015-2016
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2018
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Universidad de Guayaquil. Facultad de Ciencias Médicas. Carrera de Medicina
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La Enfermedad renal crónica (ERC) es un problema de salud pública a nivel mundial. Existen indicaciones absolutas y relativas que determinan la técnica dialítica apropiada; sin embargo, en la práctica clínica se inclina la balanza hacia el programa de hemodiálisis y uno de los principales problemas es el agotamiento de accesos vasculares nativos que imposibilita que el programa de hemodiálisis sea sostenible. Se realizó un trabajo de investigación en una muestra de 300 (n=300) pacientes que pertenecen a la Unidad de hemodiálisis del HTMC. Los resultados demuestran que el 66 % de los pacientes son masculinos, es más frecuente entre los 55 a 75 años, las fístulas autólogas (FAV) son más comunes, el 88 % de casos nuevos no tienen confeccionado acceso vascular y de ellos al 42 % se le confecciona FAV en los dos primeros meses de iniciado el tratamiento, en el 80 % de FAV protésicas y transposiciones se usaron catéteres vasculares, el 51 % presentan signos distantes al sitio de punción y los hematomas son más comunes (43 %), el principal signo a distancia es la circulación colateral, el 61 % tienen estenosis a nivel del sitio de anastomosis, el 39 % presentan estenosis a nivel central, al 40 % de las obstrucciones les han realizado procedimientos especiales tipo ATP, Angioplastia con Endo-prótesis, Bypass. Se concluyó que las FAV autólogas son más comunes, al 42 % de los casos nuevos se les confecciona acceso vascular definitivo en los dos primeros meses, las FAV protésicas y las FAV con transposición se relacionan al uso de catéteres vasculares previos (80 %), el 61 % presenta estenosis a nivel de venas y/o arterias proximales al sitio de anastomosis, el 39 % presentan estenosis a nivel central.
Chronic kidney disease (CKD) is a public health problem worldwide. There are absolute and relative indications that determine the appropriate dialysis technique; however, in clinical practice the balance is tilted towards the hemodialysis program and one of the main problems is the depletion of native vascular accesses that makes it impossible for the hemodialysis program to be sustainable. A research work was carried out on a sample of 300 (n = 300) patients belonging to the Hemodialysis Unit of the HTMC. The results show that 66% of patients are male, more frequent between 55 to 75 years, autologous fistulas (AVF) are more common, 88% of new cases have no access to vascular and 42% of them FAV was made in the first two months after starting treatment, 80% of prosthetic AVFs and transpositions were using vascular catheters, 51% had signs distant from the puncture site, and bruises were more common (43%). main sign at a distance is the collateral circulation, 61% have stenosis at the site of anastomosis, 39% have stenosis at the central level, 40% of the obstructions have made special procedures type ATP, angioplasty with Endo-prosthesis, Bypass It was concluded that autologous AVF are more common, 42% of new cases are made definitive vascular access in the first two months, prosthetic AVF and transposed AVF are related to the use of previous vascular catheters (80%), 61% have stenosis at the level of veins and / or arteries proximal to the site of anastomosis, 39% have stenosis at the central level
Chronic kidney disease (CKD) is a public health problem worldwide. There are absolute and relative indications that determine the appropriate dialysis technique; however, in clinical practice the balance is tilted towards the hemodialysis program and one of the main problems is the depletion of native vascular accesses that makes it impossible for the hemodialysis program to be sustainable. A research work was carried out on a sample of 300 (n = 300) patients belonging to the Hemodialysis Unit of the HTMC. The results show that 66% of patients are male, more frequent between 55 to 75 years, autologous fistulas (AVF) are more common, 88% of new cases have no access to vascular and 42% of them FAV was made in the first two months after starting treatment, 80% of prosthetic AVFs and transpositions were using vascular catheters, 51% had signs distant from the puncture site, and bruises were more common (43%). main sign at a distance is the collateral circulation, 61% have stenosis at the site of anastomosis, 39% have stenosis at the central level, 40% of the obstructions have made special procedures type ATP, angioplasty with Endo-prosthesis, Bypass It was concluded that autologous AVF are more common, 42% of new cases are made definitive vascular access in the first two months, prosthetic AVF and transposed AVF are related to the use of previous vascular catheters (80%), 61% have stenosis at the level of veins and / or arteries proximal to the site of anastomosis, 39% have stenosis at the central level
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Complicaciones quirúrgicas, Accesos vasculares, Diálisis renal, Hospital de Especialidades Dr. Teodoro Maldonado Carbo, Cantón Guayaquil, Ecuador, Insuficiencia renal crónica, Epidemología descriptiva, Estudios retrospectivos