摘要
目的 探讨血液透析患者动静脉内瘘（AVF）狭窄X线引导下介入治疗的方法及效果.方法 搜集自体AVF狭窄的患者24例,通过经皮穿刺血管内介入造影和治疗,观察狭窄段数目、位置及相应的治疗方式,应用K-M曲线分析AVF介入治疗后的半年开放率.结果 入组24例患者中,12例AVF存在2处狭窄,2例存在3处狭窄,其余患者内瘘有1处狭窄,共40处狭窄.狭窄多位于吻合口附近及内瘘静脉透析用穿刺段,占狭窄总个数的95.0％ （38/40）.1例患者因导丝无法通过近乎闭塞的内瘘而接受其他手术方式,21例患者采用了单纯球囊扩张,2例患者球囊扩张后植入支架.介入治疗后即刻狭窄开放22例,治疗后6个月时有17例内瘘保持畅通,总体开放率的95％可信区间为（4.410,5.940）.结论 自体动静脉内瘘狭窄经介入下血管腔内治疗后,狭窄即刻开通率高,但治疗后半年内部分患者会再次出现内瘘狭窄.
Objective To explore the intervention therapy to arteriovenous fistula （AVF） stenosis in hemodialysis patients and analyze the fistula dysfunction rate after the intervention treatment.Methods Twenty-four AVF stenosis patients were enrolled.Percutaneous anglographies and intervention therapies were carried out.The position and number of AVF were analyzed,and meanwhile the intervention therapy approaches were evaluated.The patency rates in half a year after intervention treatment to AVF were analyzed by K-M curve.Results There were forty stenoses in all patients with AVF.Twelve patients had two stenosis,two patients had three stenoses while the rest only had one.All patients received endovascular therapy except one with guide wire failing to pass through the stenosis received other therapies.The stenosis mostly lied in the peri-anastomotic region and the puncture segment of fistula.These two stenosis sites occupied ninety-five percent of all lesions.Twenty-one patients received percutaneous transluminal angioplasty,and two received stent implantation after angioplasty.After intervention therapy,twenty-two AVF were recovered to patency immediately and by the end of six months seventeen fistulas still kept well.The ninety-five percent confidence interval of patency was 4.410 to 5.940.Conclusion The AVF stenosis mostly lies in the peri-anastomotic region and the puncture segment.Though the possibility of immediate patency of fistula after intervention treatment is high,a part of patients have to suffer the dysfunction of fistula again after six months.
出处
《中华放射学杂志》
CAS
CSCD
北大核心
2014年第4期308-310,共3页
Chinese Journal of Radiology
关键词
透析
动静脉瘘
狭窄
放射学
介入性
Dialysis
Arteriovenous fistula
Stenosis
Radiology, interventional
