摘要
目的总结球囊扩张术治疗自体动静脉内瘘(AVF)狭窄或闭塞的临床效果及应用体会。方法选取2013年1月至2016年6月采用球囊扩张治疗自体AVF狭窄或闭塞的尿毒症患者52例,比较手术前后自体瘘血流量的变化及造影表现,并分析治疗效果。结果 52例患者球囊扩张手术成功率为100%,术后随访3、6、9、12个月通畅率分别为98.1%(51/52)、90.4%(47/52)、80.8%(42/52)、71.2%(37/52);术后1年内再狭窄患者15例,经再次球囊扩张后血流量达到透析要求(>200 mL·min-1)。结论球囊扩张是治疗自体AVF狭窄的有效方法,近期效果明显;超声或数字减影造影引导下经皮血管成形术均可行,可根据患者病变情况和医生自身技术条件酌情选择;手术入路和球囊的选择对于治疗AVF狭窄至关重要;球囊扩张治疗自体AVF狭窄通畅率随时间降低,远期效果有待进一步观察。
Objective To summarize the clinical efficacy of balloon dilationin the treatment of autogenous arteriovenous fistula(AVF)stenosis or occlusion. Methods Fifty-two patients with AVF stenosis were treated with balloon dilation between January 2013 and June 2016.The blood flow volume in AVF and findings of digital subtraction angiography(DSA)were observed before and after operation to analyze the therapeutic effect. Results The success rate ofballoon dilation was 100%.After follow-up for 3,6,9 and 12 months,the patency rates were 98.1%(51/52), 90.4%(47/52),80.8%(42/52) and 71.2%(37/52),respectively.Fifteen patients had restenosis within 1 year after operat ion.However,the blood flow volumemet dialysis requirement(>200 mL· min^-1 ) after the second balloon dilation. Conclusion Balloon dilation has significant short-term effectivenessfor treating AVF stenosis.Percutaneous transluminal angioplasty can be performed under ultrasound or DSA guidance,which should be chosen according to patient’s condition and doctor’s technique.The selection of operative approach and balloon is critical for the treatment of AVF stenosis.The patency rate decreases with time after balloon dilation,and the long-term effect needs to be further studied.
作者
周卫
朱仙花
熊清根
曾庆福
陈锋
ZHOU Wei;ZHU Xian-hua;XIONG Qing-gen;ZENG Qing-fu;CHEN Feng(Department of Vascular Surgery,the Second Affiliated Hospital of Nanchang University,Nanchang 330006,China)
出处
《南昌大学学报（医学版）》
CAS
2018年第6期61-65,共5页
Journal of Nanchang University：Medical Sciences
关键词
球囊扩张术
动静脉内瘘
自体
狭窄
闭塞
血液透析
balloon dilation
arteriovenous fistula,autogenous
stenosis
occlusior
dialysis
