血液透析血管通路失败：从基础理论到临床实践的全面综述

Hemodialysis Vascular Access Failure: A Comprehensive Review from Basic Science to Clinical Practice

摘要: 本文全面综述了血液透析血管通路失败的相关研究，涵盖了基础理论、临床实践、技术进展、历史演变、现状分析、未来展望及争议点等多个方面。在基础理论部分，阐述了不同类型的血管通路(如动静脉瘘、动静脉移植物和隧道式导管)、其病理机制及流行病学特征；临床实践部分聚焦于诊断技术、治疗策略与临床管理经验；技术进展部分介绍了影像学评估、生物标志物研究及微创介入技术的应用；历史演变部分回顾了血管通路管理的发展历程、早期研究及经典案例；现状分析探讨了现有预测模型、多中心研究结果及国际指南共识；未来展望则提出了创新预测模型、个性化治疗策略及新的研究方向；争议点围绕风险因素辨识、预防措施的有效性及长期管理策略展开讨论。本文旨在为血液透析血管通路失败的研究与临床实践提供全面参考，以提升患者的治疗效果和生活质量。

Abstract: This paper provides a comprehensive review of research on hemodialysis vascular access failure, covering multiple aspects including basic theories, clinical practice, technological advancements, historical evolution, current status analysis, future perspectives, and controversial issues. The basic theory section elaborates on different types of vascular access (such as arteriovenous fistula, arteriovenous graft, and tunneled catheter), their pathological mechanisms, and epidemiological characteristics. The clinical practice section focuses on diagnostic techniques, treatment strategies, and clinical management experience. The technological advancements section introduces applications of imaging evaluation, biomarker research, and minimally invasive intervention techniques. The historical evolution section reviews the development process of vascular access management, early studies, and classic cases. The current status analysis discusses existing prediction models, multicenter study results, and international guideline consensus. The future perspectives section proposes innovative prediction models, personalized treatment strategies, and new research directions. Controversial issues center around risk factor identification, effectiveness of preventive measures, and long-term management strategies. This review aims to provide a comprehensive reference for research and clinical practice regarding hemodialysis vascular access failure, with the goal of improving patient treatment outcomes and quality of life.