高压球囊对比普通球囊治疗自体动静脉内瘘狭窄疗效的前瞻性分析  

Prospective study of high-pressure balloon angioplasty compared with conventional balloon angioplasty in treatment of arteriovenous fistula stenosis

作　　者：王耿[1] 陈志强[1] 李孝虎[1] 庄佩佩 吴权辉[1] 

机构地区：[1]中山市中医院血管介入科,广东中山528400

出　　处：《中国血管外科杂志（电子版）》2016年第1期53-56,共4页Chinese Journal of Vascular Surgery(Electronic Version)

摘　　要：目的比较高压球囊与普通球囊临床应用于自体动静脉内瘘(AVF)狭窄的手术成功率及疗效。方法对2014年3月至2015年3月本院收治的40例AVF狭窄或闭塞患者进行介入治疗,随机分为高压球囊组(RBP 24 atm)和普通球囊组(RBP 14 atm),每组各20例,比较两组血管形成术后手术成功率,扩张压力、通畅率。结果高压球囊组与普通球囊手术成功率分别为100%和80%(P=0.035);高压球囊组扩张压力较普通球囊组高,扩张次数较少。高压球囊组与普通球囊组的平均扩张压力分别为(15.40±0.844)atm和(13.20±0.601)atm(P=0.040),平均扩张次数分别为(1.25±0.099)次和(2.05±0.15)次(P<0.001),其中18例患者需要使用﹥15 atm的球囊扩张压力,无出血等并发症。随访6个月无死亡病例,术后6个月高压球囊组和普通球囊组开放率分别为80%和50%(P=0.047)。结论高压球囊在手术成功率、6个月开放率均优于普通球囊,45%的自体动静脉内瘘病变需要﹥15atm的扩张压力。Obiective To prospectively study and compare the efficacy and surgical success rate of high-pressure balloon angioplasty（HPBA） with conventional balloon angioplasty（CBA） in native arteriovenous fistula（AVF） stenoses. Methods The data of 40 patients with native AVF stenosis,who randomly underwent CBA（CBA group, n =20） or HPBA（HPBA group, n =20）, in our centre from Mar. 2014 to Mar. 2015 were analyzed. The outcomes of operation success, expansion pressure and patency rate were assessed.Results Technical success rate was 100% and 80% in HPBA group and CBA group, respectively（P=0.035）.HPBA group needed higher expansion pressure and less expansion times than CBA group.The average expansion pressure and expansion times were 15.40±0.844 atm, 1.25±0.099 and 13.20±0.601 atm, 2.05±0.15 in HPBA group and CBA group,respectively（P=0.040,P〈0.001）. Eighteen patients required pressures greater than 15 atm without bleeding and other complications. Six months after procedure,primary target lesion patency rate was 80% and 50% in HPBA group and CBA group, respectively（P=0.047）. And no death occurred in follow-up. Conclusion Technical success rate and primary target lesion patency rate at6 months postoperatively of HPBA group are statistically superior to CBA group, and 45% patients require high pressures（15 atm）.

关 键 词：高压球囊 普通球囊 自体动静脉内瘘狭窄 血管成形术 

分 类 号：R692.5[医药卫生—泌尿科学]