摘要
目的探讨动静脉移植物内瘘(AVG)行经皮腔内球囊血管成形(PTA)术后初级通畅时间的影响因素。方法回顾性分析2018年2月至2021年12月在重庆医科大学附属第一医院行AVG置入的血液透析患者资料。分析年龄、性别、AVG使用时间、狭窄部位、狭窄程度、狭窄长度、残余狭窄、是否合并血栓形成等因素,采用多重线性回归模型分析PTA术后初级通畅时间的影响因素。结果纳入101例患者,其中男35例,女66例,首次接受PTA的年龄[M(Q_(1),Q_(3))]为61(51,68)岁,随访时长(38.5±15.3)个月,PTA术后初级通畅时间为5(3,10)个月,共计331次PTA治疗。多重线性回归分析结果显示,静脉端吻合口和回流静脉闭塞(β=-2.773,95%CI:-5.440~-0.105,P=0.042)、女性(β=-2.247,95%CI:-3.853~-0.642,P=0.006)及既往PTA处理次数多(β=-0.516,95%CI:-0.978~-0.054,P=0.029)为PTA术后初级通畅时间短的危险因素。结论AVG静脉端吻合口和回流静脉狭窄程度、女性及既往多次PTA治疗与AVG患者PTA术后初级通畅时间短相关。
Objective To investigate the factors affecting primary patency time in arteriovenous graft(AVG)patients receiving percutaneous transluminal balloon angioplasty(PTA).Methods Hemodialysis patients who underwent AVG placement at the First Affiliated Hospital of Chongqing Medical University between February 2018 and December 2021 were included.The factors including age,gender,total duration of AVG use,site of stenosis,degree of stenosis,length of stenosis,residual stenosis,and presence of thrombosis were analyzed,and influencing factors of primary patency time in AVG were determined using a multiple linear regression model.Results A total of 101 patients who underwent 331 PTA treatments were enrolled,including 35 males and 66 females.The median age of patients undergoing PTA for the first time was 61(51,68)years,and the primary patency time after PTA was 5(3,10)months.The patients were followed up for(38.5±15.3)months.Multivariable linear regression analysis revealed that severe stenosis at the venous anastomosis and reflux veins(β=-2.773,95%CI:-5.440--0.105,P=0.042),female(β=-2.247,95%CI:-3.853--0.642,P=0.006),and previous multiple PTA treatments(β=-0.516,95%CI:-0.978--0.054,P=0.029)were risk factors for a shorter primary patency time after PTA.Conclusion Severity of stenosis at the venous anastomosis and reflux veins of the AVG,female,and a history of multiple previous PTA treatments are associated with a shorter primary patency time in AVG patients.
作者
李相杰
郑国富
赵霞
孙浩
傅麒宁
Li Xiangjie;Zheng Guofu;Zhao Xia;Sun Hao;Fu Qining(Department of Vascular Surgery,the First Affiliated Hospital of Chongqing Medical University,Chongqing 401122,China;Department of Vascular Surgery,Ganzhou People′Hospital,Ganzhou 341000,China)
出处
《中华医学杂志》
CAS
CSCD
北大核心
2024年第32期3037-3041,共5页
National Medical Journal of China
关键词
血液透析
动静脉瘘
血管成形术
气囊
Hemodialysis
Arteriovenous fistula
Angioplasty
Balloon
