超声引导下球囊扩张在维持性血液透析患者动静脉内瘘狭窄的应用  

Application of ultrasound-guided balloon expansion for arteriovenous fistula stenosis in patients with maintenance hemodialysis

作　　者：孟一 王春燕[1] 王朝晖 涂波[2] MENG Yi;WANG Chunyan;WANG Zhaohui;TU Bo(Department of Ultrasound,Sichuan Mianyang 404 Hospital,Mianyang 621000,P.R.China;Department of Ultrasound,First Affiliated Hospital,Chongqing Medical University,Chongqing 400016,P.R.China)

机构地区：[1]四川绵阳四0四医院医学超声科,四川绵阳621000 [2]重庆医科大学附属第一医院超声科,重庆400016

出　　处：《医学影像学杂志》2018年第4期632-635,共4页Journal of Medical Imaging

摘　　要：目的探讨超声引导下球囊扩张在维持性血液透析(MHD)患者动静脉内瘘(AVF)狭窄中的应用。方法将78例AVF狭窄的MHD患者随机分为两组,各39例。对照组、观察组分别采用数字减影血管造影(DSA)、彩色多普勒超声(CDFI)引导下球囊扩张。比较两组穿刺成功率、内瘘功能恢复情况及手术并发症发生率。结果观察组一次穿刺成功率为100.0%,显著高于对照组84.6%(P<0.05);两组术后血管内径、透析血流量均有明显改善,而观察组的改善程度显著优于对照组(P<0.05);观察组手术并发症的总发生率为5.1%,显著低于对照组20.5%(P<0.05)。结论超声引导下球囊扩张治疗MHD患者AVF狭窄,可提高穿刺成功率,降低手术并发症,更好地修复内瘘功能。Objective To explore the application of ultrasound-guided balloon expansion for arteriovenous fistula(AVF)stenosis in patients with maintenance hemodialysis(MHD).Methods 78 MHD patients with AVF stenosis were randomly divided into two groups.Control group(n=39)and observation group(n=39)were given digital subtraction angiography(DSA),color doppler flow imaging(CDFI)-guided balloon expansion,respectively.The success rate of puncture,recovery of internal fistula function,and surgical complications beteen two groups were compared.Results The success rate of once puncture in observation group was 100.0%,which was significantly higher than 84.6%of control group(P<0.05).The inner diameter of blood vessel,blood flow of dialysis in both groups were improved significantly after surgery,and the improvement in observation group was superior to that in control group(P<0.05).The total incidence of surgical complications in observation group was 5.1%,which was significantly lower than 20.5%in control group 20.5%(P<0.05).Conclusion Ultrasound-guided balloon expansion for AVF stenosis in patients with MHD can improve success rate of puncture,reduce surgical complications,and better repair function of internal fistula.

关 键 词：动静脉内瘘狭窄 超声引导 球囊扩张术 维持性血液透析 

分 类 号：R543[医药卫生—心血管疾病] R445.1[医药卫生—内科学]