经皮球囊扩张术治疗血透通路狭窄的技术成功率与一期通畅率的相关性研究  

The relationship between the technical success rate and primary patency rate in percutaneous transluminal angioplasty treatment for dialysis access stenosis

作　　者：朱峥嵘[1] 邹岚[1] 邢越[1] 谭羽灿[1] 徐国建[1] 何志坚[1] 曹健强[1] 吴嘉瑜 罗灿华[1] ZHU Zheng-rong;ZOU Lan;XING Yue;TAN Yu-can;XU Guo-jian;HE Zhi-jian;CAO Jian-qiang;WU Jia-yu;LUO Can-hua(Division of Vascular Surgery,The First People's Hospital of Foshan,Foshan 528000,China)

机构地区：[1]佛山市第一人民医院血管外科,广东佛山528000

出　　处：《中国血管外科杂志（电子版）》2018年第3期196-200,共5页Chinese Journal of Vascular Surgery(Electronic Version)

基　　金：佛山市医学类科技攻关项目(2015AB00323)

摘　　要：目的探讨经皮球囊扩张(PTA)治疗前臂Brescia-Cimino内瘘(B-C AVF)狭窄的技术成功(TS)率与一期通畅率的相关性,同时分析影响TS的相关因素。方法回顾性分析2013年11月至2018年3月本中心经PTA治疗的B-C AVF狭窄病例,对比分析技术不成功(TF)组和TS组的一期通畅率,探讨影响TS的相关因素。结果共74例患者纳入研究,整体一期通畅时间为(7.79±0.48)个月,TS组(41例)一期通畅时间为(9.77±0.61)个月,优于TF组(33例)的一期通畅时间(5.42±0.53)月(P<0.01)。TF组使用普通球囊比例更高(54.5%),而TS组使用高压球囊比例更高(68.3%)(P=0.048),TF组比TS组需要多次扩张(>2次)的比例更高(90.9%VS 24.4%)(P=0.001)。结论 PTA治疗B-C AVF狭窄中,TS可以延长一期通畅时间,提高通畅率,使用高压球囊可以增加TS率,从而减少球囊的多次扩张。Objective To investigate the correlation between technical success(TS)rate and primary patency rate of percutaneous transluminal angioplasty(PTA)in Brescia-Cimino arteriovenous fistula(B-C AVF)stenosis,meanwhile,to analyze the relative factors about TS.Methods The patients diagnosed with B-C AVF stenosis and treated by PTA in our hospital from November 2013 to March 2018 were analyzed retrospectively.The Kaplan-Meier curve was used to analyze the primary patency rate between TS group and technical failure(TF)group.The chi-square test was used to investigate the relative factors about TS.Results Seventy-four patients of B-C AVF stenosis treated by PTA were enrolled in this study,whose primary patency time was(7.79±0.48)months.The primary patency time in TS group(n=41)was significantly longer than that in TF group(n=33)[(9.77±0.61)months vs(5.42±0.53)months,P<0.01].The proportion of plain balloon was higher in TF group(54.5%)while the proportion of high-pressure balloon was higher in TS group(68.3%)(P=0.048).The proportion of multiple dilation(>2 times)was higher in TF group than in TS group(90.9%vs 24.4%,P=0.001).Conclusion TS could improve the primary patency of B-C AVF stenosis treated by PTA.The TS rate increases and dilation time decreases after high-pressure balloon application.

关 键 词：动静脉内瘘 狭窄 腔内 球囊扩张 技术成功 残余狭窄 

分 类 号：R459.5[医药卫生—治疗学]