Pengamatan Thrill dan Bruit pada Prosedur AV Fistula dengan Tehnik Radial-Cephalic dan Brachial-Cephalic pada Penderita Gagal Ginjal Kronis di RSUP H Adam Malik Medan

Abstract

AV fistule is surgery which serves to make the veins into the arterial system for the purpose of hemodialysis in patients with chronic renal failure. Various techniques can be used for the manufacture of this procedure are (1) the radial artery and cephalica vein (radial-cephalic fistule), (2) the brachial artery and cephalica vein (brachial-cephalic fistule), (3) the brachial artery and basilica vein (brachial-basilic fistule). For grafting techniques, among others, (1) Side to side anastomosis, (2) End to side anastomosis, (3) End-to-end anastomosis. From some of the above access, AV fistula procedure is often performed in the department H.Adam Malik is radial-cephalic fistule and brachial-cephalic frstule with end-to-side grafting technique anastomosis. Objectives:

To determine the incidence of thrill and bruit in the AV fistule procedure technique of radial- cephalic and brachial-cephalic presentation in patients with chronic renal failure at RSUp H.

Adam Malik. Material and methodology: This study is an observational study with the analytical observation Thdll and bruit in the AV fistule procedure with radial-cephalic fistule technique and brachial-cephalic fistule in patients with chronic renal failure requiring hemodialysis access at RSUP I-I. Adarn lv{alik. Each sample

of 20 patients (10 patients with radial-cephalic fistule performed, 10 patients performed brachial- cephalic fistule). The examination was conducted between 7 days postoperatively. The results

were analyzed with Fisher's test. The data presented in the form of text, tables and graphs. Results : The samples we comparcd,20 patients, 9 men and ll women. Distribution of patient age ranged from 35-65 years with an age range of 5l-60 years most by 8 (a0%) patients. In the group of radial-cephalic fistule incidence obtained thrill and bruit only 5 (33.3%) patients, whereas in the brachial-cephalic fistule failure was not obtained (66.7%). Fisher's test showed significant results between the two procedures @:0.016). The larger the diameter of the arteries and veins encountered greater thrill and bruit (p:0.009). Conclusion: Event of thrill and bruit on brachial-cephalic fistule more often than radial-cephalic fistule The larger the diameter of the arteries and veins encountered greater thrill and bruit