摘要
2014年4月至2016年4月行血液透析治疗、因动静脉瘘血管狭窄行经皮腔内血管成形术（PTA）治疗患者32例，其中24例为自体动静脉瘘（AVF）、8例为人工血管动静脉瘘（AVG）。AVF患者血流量下降者20例（均为吻合口狭窄），静脉压增高者4例（均为静脉流出道狭窄）；AVG患者均无透析血流量下降，均有静脉压增高（均为静脉流出道狭窄），两者比较差异有统计学意义（χ2＝17.77，P＜0.001）。 PTA治疗后，吻合口狭窄患者和静脉流出道狭窄患者狭窄部位的血管内径[（1.2±0.1）比（3.6±0.2） mm，t＝18.52，P＜0.001；（1.3±0.3）比（3.7±0.4） mm，t＝18.67，P＜0.001]均增大，吻合口狭窄患者透析血流量[（150.5±23.1）比（265.4±21.5） ml／min，t＝21.81， P＜0.001]增大，而静脉压[（68.6±8.7）比（69.3±6.1） mmHg（1 mmHg＝0.133 kPa）]无明显变化（P＞0.05），流出道狭窄患者静脉压[（170.4±15.7）比（71.2±7.9） mmHg，t＝34.62，P＜0.001]下降，而透析血流量[（260.7±17.3）比（264.1±15.2） ml／min]无明显变化（P＞0.05）。
Arteriovenous fistula stenosis developed in 32 patients who received hemodialysis from April 2014 to April 2016, including 24 cases of autologous arteriovenous fistula （ AVF） and 8 cases of artificial vessel arteriovenous fistula （ AVG）.In AVF patients, there were 20 cases with blood flow decreasing and 4 cases of venous hypertension , while in AVG patients there were no cases with blood flow decreasing and 8 cases with venous pressure increasing （χ2 =17.77, P〈0.001）.All patients underwent percutaneous transluminal angioplasty （ PTA ） . In all patients the vascular diameter was increased significantly after PTA treatment [（3.6 ±0.2） vs.（1.2 ±0.1） mm, t=18.52, P〈0.001].The blood flow during hemodialysis was increased significantly after PTA treatment in patients with anastomoti stenosis [（265.4 ±21.5） vs.（ 150.5 ±23.1 ） ml/min, t =21.81, P 〈0.001 ]; however, there were no significant changes in venous pressure [（68.6 ±8.7） vs.（69.3 ±6.1） mmHg（1 mmHg=0.133 kPa）, P〉0.05].The blood pressure was decreased after PTA treatment [（ 71.2 ±7.9 ） vs.（ 170.4 ± 15.7） mmHg, t=34.62, P〈0.001] in patients with venous outflowtract stenosis , however, there were no significant changes in the blood flow [（264.1 ±15.2） vs.（260.7 ±17.3） ml/min, t=1.04, P〉0.05].
作者
陈彬
Chen Bin(Department of Nephrology, Ningbo Seventh Municipal Hospital, Ningbo 315200, Zhejiang, China)
出处
《中华全科医师杂志》
2017年第1期61-63,共3页
Chinese Journal of General Practitioners
基金
宁波市镇海区社会发展科技项目（2015S1013）
关键词
血管成行术
气囊
动静脉瘘
Angioplasty,balloon
Arteriovenous fistula
