B超引导下经皮腔内血管成形术治疗自体动静脉内瘘狭窄的临床效果  

Clinical effects of percutaneous transluminal angioplasty guided by B-ultrasound in treatment of stenosis of autogenous arteriovenous fistula

作　　者：章圣泽 周丽娜 董芍芍 朱源 王牡丹 ZHANG Shengze;ZHOU Li-na;DONG Shaoshao;ZHU Yuan;WANG Mudan(Department of Nephrology,Wenzhou People′s Hospital,Zhejiang Province,Wenzhou 325000,China)

机构地区：[1]浙江省温州市人民医院肾内科,浙江温州325000

出　　处：《中国医药导报》2018年第8期120-123,共4页China Medical Herald

基　　金：浙江省温州市科技计划项目(Y20170323)

摘　　要：目的探究B超引导下经皮腔内血管成形术(PTA)治疗自体动静脉内瘘(AVF)狭窄的临床效果。方法选取2016年1月~2017年12月温州市人民医院收治的30例维持性规律血液透析AVF狭窄病例纳入研究,均在B超引导下实施经皮血管腔内血管成形术(PTA),比较患者手术前、术后即刻、术后1 d、术后3 d内瘘狭窄血管内径(D)、横断面积(S)、狭窄部位峰值流速(Vmax)、肱动脉阻力指数(RI)、手术成功率、术后内径狭窄率及并发症情况。结果相较于手术前,患者术后即刻内瘘狭窄血管D与S明显增加(P<0.05),Vmax、肱动脉RI明显降低(P<0.05),术后1 d与术后3 d内瘘狭窄血管D、S明显大于术后即刻(P<0.05),且刻狭窄部位Vmax、肱动脉RI明显低于术后即刻(P<0.05),术后1 d与术后3 d内瘘狭窄血管D、S、Vmax、肱动脉RI比较差异无统计学意义(P>0.05);手术成功率为100.00%,术后并发症总发生率为6.67%,经处理完全消退。结论 B超引导下PTA治疗AVF操作简单、安全性高等特点,能显著改善狭窄处血流速度及管腔直径,提高手术成功率,值得临床推广。Objective To observe the clinical efficacy of percutaneous transluminal angioplasty(PTA)in treatment of patients with autogenous arteriovenous fistula(AVF)under the guidance of B-ultrasound.Methods Thirty cases of AVF stenosis patients with maintenance hemodialysis treated in Wenzhou People′s Hospital from January 2016 to December 2017 were enrolled in the study.All patients were given the percutaneous transluminal angioplasty(PTA)under B-ultrasound.The fistula stenosis vascular diameter(D),cross-sectional area(S),stenosis peak velocity(Vmax),brachial artery resistance index(RI),operation success rate,the postoperative diameter stenosis rate and complications were compared before operation,immediately after operation,and at 1,3 d after operation.Results Compared with before operation,the D and S of the fistula stenosed vessels were significantly increased(P<0.05),while the Vmax and brachial artery RI were significantly decreased(P<0.05),and the D and S of the fistula stenosed vessels at 1,3 d after operation were significantly higher than those immediately after operation(P<0.05),while the stenosis site Vmax and brachial artery RI were significantly lower than those immediately after operation(P<0.05),and there was no significant difference in the D,S,Vmax and brachial artery RI between at 1 d after operation and at 3 d after operation(P>0.05).The operation success rate was 100.00%,and the total incidence of postoperative complications was 6.67%.The complications were completely subsided after treatment.Conclusion PTA under B-ultrasound for AVF has the features of simple operation and high safety,and it can significantly improve the blood flow velocity and lumen diameter of stenosis site,and enhance the success rate of surgery,therefore it is worthy of clinical promotion.

关 键 词：B超 介入治疗 经皮血管腔内血管成形术 自体动静脉内瘘 狭窄 

分 类 号：R445.1[医药卫生—影像医学与核医学]