摘要
目的分析超声下经皮腔内血管成形术(PTA)治疗自体动静脉内瘘(AVF)狭窄的效果。方法选取郑州市第三人民医院血液净化中心的2018年1月-2022年5月期间收治的AVF狭窄者42例作为研究对象进行回顾性分析,均行超声下PTA治疗,收集纳入对象的基线资料以及围术期临床资料,观察手术前后透析血流量、狭窄处血管内径变化,统计临床成功率、技术成功率与并发症发生率、术后3个月、6个月、9个月、12个月初级通畅率、次级通畅率以及术后6个月、12个月的内瘘再狭窄发生率。结果技术成功率为97.61%(41/42);临床成功率达97.56%(40/41);术后3个月、6个月、9个月、12个月初级通畅率分别为94.59%(35/37)、78.38%(29/37)、62.16%(23/37)、51.35%(19/37);术后3个月、6个月、9个月、12个月次级通畅率分别为100.00%(37/37)、97.30%(36/37)、91.89%(34/37)、86.49%(32/37);术后并发症总发生率为13.51%(5/37);术后6个月再狭窄率为21.62%(8/37),术后12个月再狭窄率为48.65%(18/37);术后透析血流速度、狭窄处内径均大于术前(P<0.05)。结论超声下PTA治疗AVF狭窄患者效果显著,可改善内瘘通畅率,增加透析血流速度与狭窄处内径。
Objective To analyze the effect of percutaneous transluminal angioplasty(PTA)in the treatment of autologous arteriovenous fistula(AVF)stenosis.Methods A total of 42 patients with autologous AVF stenosis admitted to the Blood Purification Center of Zhengzhou Third People's Hospital from January 2018 to May 2022 were selected as the study subjects for retrospective analysis.All patients received PTA treatment under ultrasound.Baseline and perioperative clinical data of the included subjects were collected.The hemodialysis blood flow and the internal diameter of the stenosis were observed before and after operation,and the clinical success rate,technical success rate and complication rate,the primary patency rate and secondary patency rate at 3 months,6 months,9 months and 12 months after surgery,and the incidence of internal fistula restenosis at 6 months and 12 months after surgery were analyzed.Results The success rate was 97.61%(41/42).The clinical success rate was 97.56%(40/41).The primary patency rates at 3,6,9 and 12 months were 94.59%(35/37),78.38%(29/37),62.16%(23/37)and 51.35%(19/37),respectively.The secondary patency rates at 3 months,6 months,9 months and 12 months were 100.00%(37/37),97.30%(36/37),91.89%(34/37)and 86.49%(32/37)respectively.The total incidence of postoperative complications was 13.51%(5/37).The restenosis rate was 21.62%(8/37)at 6 months and 48.65%(18/37)at 12 months.The postoperative hemodialysis flow velocity and stenosis diameter were higher than those before operation(P<0.05).Conclusion Ultrasonic PTA is effective in the treatment of autologous AVF stenosis,which can improve the patency rate of internal fistula,increase the dialysis blood flow velocity and the inner diameter of the stenosis.
作者
李岩岩
宋丹丹
祝文婷
夏伟
程艳
LI Yan-yan;SONG Dan-dan;ZHU Wen-ting;XIA Wei;CHENG Yan(Inarenal Rheumatology,Zhengzhou Third People's Hospital,Zhengzhou 450000,Henan Province,China)
出处
《罕少疾病杂志》
2024年第4期110-111,114,共3页
Journal of Rare and Uncommon Diseases
基金
2022年度河南省医学科技攻关计划联合共建项目(LHGJ20220822)。
关键词
经皮腔内血管成形术
自体动静脉内瘘
血液透析
狭窄
通畅率
Percutaneous Transluminal Angioplasty
Arteriovenous Fistula
Hemodialysis
Narrow
Patency Rate
