摘要
目的探讨超声引导下球囊扩张治疗血液透析患者上肢动静脉瘘管腔狭窄的安全性和有效性.方法选取2016年1月~2018年1月于我院行血液透析治疗并出现上肢动静脉瘘管腔狭窄的40例患者作为研究对象,按照随机数字表法将其分为对照组与观察组,每组各20例.对照组患者在数字血管造影下行球囊扩张治疗,观察组患者在超声引导下行球囊扩张治疗.比较两组患者的球囊扩张效果(球囊扩张次数、球囊扩张压力、手术成功率)以及扩张前后血管内径及透析血流量,并记录随访情况.结果观察组患者的球囊扩张次数明显少于对照组,球囊扩张压力及手术成功率均高于对照组,差异有统计学意义(P<0.05).两组患者扩张前的血管内径及透析血流量比较,差异无统计学意义(P>0.05);两组患者扩张后的血管内径均大于扩张前,透析血流量均多于扩张前,差异有统计学意义(P<0.05);观察组患者扩张后的血管内径大于对照组,透析血流量多于对照组,差异有统计学意义(P<0.05).本研究40例患者均采用单纯球囊扩张,经介入治疗后成功开通38例(95.00%),在后续的血液透析过程中内瘘保持开放3、4、5、6个月者的占比分别为95.00%、82.50%、75.00%、67.50%.结论采用超声引导下球囊扩张治疗血液透析患者上肢动静脉瘘管腔狭窄安全有效,值得在临床推广使用.
Objective To explore the safety and effectiveness of ultrasound-guided balloon dilatation in the treatment of arteriovenous fistula stenosis of upper extremities for hemodialysis patients. Methods Forty patients with hemodialysis treatment and upper extremity arteriovenous fistula stenosis in our hospital from January 2016 to January 2018 were enrolled in the study. They were divided into control group and observation group according to the random number table method, 20 cases in each group. Patients in the control group underwent balloon dilatation under digital angiography, and patients in the observation group underwent ultrasound-guided balloon dilatation. The balloon dilatation effect (number of balloon dilatation, balloon dilation pressure, the success rate of surgery) and vascular diameter and dialysis blood flow before and after dilatation were compared between the two groups, and follow-up results were recorded. Results The number of balloon dilatation in the observation group was significantly fewer than that in the control group, the balloon dilatation pressure and the success rate of surgery were higher than those in the control group, and the differences were statistically significant (P<0.05). There were no significant differences in the vascular diameter and dialysis blood flow between the two groups before dilatation (P>0.05). The vascular diameter after dilatation in both groups was greater than that before dilatation, the dialysis blood flow was more than that before dilatation, and the differences were statistically significant (P<0.05). The vascular diameter after dilatation in the observation group was greater than that in the control group, the dialysis blood flow was more than that in the control group, and the differences were statistically significant (P<0.05). In the study, 40 patients underwent balloon dilatation alone,and 38 patients (95.00%) were successfully opened after interventional therapy. The proportion of patients whose internal fistulas remained open for 3, 4, 5, and 6 months
作者
康文慧
莫怡浩
KANG Wen-Hui;MO Yi-Hao(Department of Ultrasound, People's Hospital of Longhua, Shenzhen, Guangdong Province, Shenzhen 518109, China;Department of Nephrology, People's Hospital of Longhua, Shenzhen, Guangdong Province, Shenzhen 518109, China)
出处
《中国当代医药》
2019年第15期54-57,共4页
China Modern Medicine
基金
广东省深圳市龙华区科技计划基础研究项目(20150924A1030080)
关键词
球囊扩张
血液透析
上肢动静脉瘘管腔狭窄
安全性
有效性
Balloon dilatation
Hemodialysis
Upper extremity arteriovenous fistula stenosis
Safety
Effectiveness
