摘要
目的观察血管钙化对以超声引导下经皮腔内血管成形(UG-PTA)干预动静脉瘘(AVF)狭窄后通畅率的影响。方法回顾性分析48例因自体或人工AVF狭窄而接受UG-PTA的慢性肾脏病维持性血液透析(HD)患者,根据超声所示有无AVF钙化将其分为钙化组(n=21)及非钙化组(n=27);记录UG-PTA技术成功率、临床治疗成功率及UG-PTA相关不良事件。分别于UG-PTA后3、6、9、12、24及36个月以超声评价AVF通畅情况,计算初级及次级通畅率,并以Kaplan-Meier生存曲线进行分析。结果对48例均于UG-PTA后成功实施3次以上有效HD,UG-PTA技术及临床治疗成功率均为100%(48/48);未见严重不良事件。钙化组UG-PTA后3、6、9、12、24及36个月初级通畅率分别为75.89%、37.95%、37.95%、27.10%、14.46%及0,次级通畅率分别为95.24%、95.24%、95.24%、89.95%、83.03%及83.03%;非钙化组初级通畅率分别为92.31%、73.08%、57.69%、53.85%、36.15%及36.15%,次级通畅率分别为100%、100%、100%、100%、95.24%及95.24%;钙化组初级通畅率低于非钙化组(P<0.05),而组间次级通畅率差异无统计学意义(P>0.05)。结论以UG-PTA干预AVF狭窄后,局部血管钙化为其初级通畅率的危险因素,但对次级通畅率无明显影响。
Objective To explore the impact of vascular calcification on patency rate of arteriovenous fistula(AVF)after ultrasound-guided percutaneous transluminal angioplasty(UG-PTA)for stenosis.Methods Forty-eight chronic kidney disease patients who underwent maintenance hemodialysis(HD)and received UG-PTA since autologous or artificial AVF stenosis were retrospectively enrolled.The patients were divided into calcification group(n=21)and noncalcification group(n=27)according to ultrasonic findings of AVF calcification or not.The technical success rate of UG-PTA,the clinical success rate and UG-PTA related adverse events were recorded.Ultrasound was performed to evaluate the patency of AVF 3,6,9,12,24 and 36 months after UG-PTA,and the primary and secondary patency rates were calculated.Kaplan-Meier survival curves were used to analyze the patency rates of AVF.Results UG-PTA was successfully performed in all 48 cases.All patients completed more than 3 times effective HD,the technical and clinical success rate both of 100%(48/48).No serious adverse event occurred.In calcification group,the primary patency rate 3,6,9,12,24 and 36 months after UG-PTA was 75.89%,37.95%,37.95%,27.10%,14.46%and 0,and the secondary patency rate was 95.24%,95.24%,95.24%,89.95%,83.03%and 83.03%,respectively,while in noncalcification group the primary patency rate was 92.31%,73.08%,57.69%,53.85%,36.15%and 36.15%,and the secondary patency rate was 100%,100%,100%,100%,95.24%and 95.24%,respectively.After UG-PTA,the primary patency rate in calcification group was lower than that in non-calcification group(P<0.05),but there was no significant difference of the secondary patency rate between groups(P>0.05).Conclusion Calcification was a risk factor for primary patency rate of AVF after UG-PTA for stenosis,but had no significant impact on the secondary patency rate.
作者
何杭
刘旻
王笑薇
余康敏
HE Hang;LIU Min;WANG Xiaowei;YU Kangmin(Department of Vascular Surgery,the First Affiliated Hospital of Anhui Medical University,Hefei 230000,China;Blood Purification Center,the First Affiliated Hospital of Anhui Medical University,Hefei 230000,China)
出处
《中国介入影像与治疗学》
北大核心
2024年第9期540-544,共5页
Chinese Journal of Interventional Imaging and Therapy
关键词
动静脉瘘
钙质沉着症
血管成形术
超声检查
介入性
arteriovenous fistula
calcinosis
angioplasty
ultrasonography,interventional
