血液透析血管通路相关假性动脉瘤12例临床分析  

Clinical analysis of 12 cases of pseudoaneurysm associated with hemodialysis

作　　者：冯珍[1] 郭岚[1] 董春霞[1] 史亚男[1] 焦荣红[2] Feng Zhen;Guo Lan;Dong Chunxia;Shi Yanan;Jiao Ronghong(Department of Nephrology,Hebei General Hospital,Shijiazhuang 050051,China;Department of Function,Hebei General Hospital,Shijiazhuang 050051,China)

机构地区：[1]河北省人民医院肾内科,河北石家庄050071 [2]河北省人民医院功能科,河北石家庄050071

出　　处：《临床荟萃》2019年第2期144-147,共4页Clinical Focus

摘　　要：目的分析血液透析患者穿刺血管通路所致假性动脉瘤的相关因素,探讨临床如何预防并及时诊治此严重并发症。方法回顾性分析我院收治的12例血液透析血管通路相关假性动脉瘤患者的临床特点与导致假性动脉瘤可能的危险因素,进一步了解假性动脉瘤的特征及处理方法。结果血液透析患者血管通路相关假性动脉瘤可能与直接穿刺动脉、穿刺不顺利、动静脉内瘘使用不规范、透析过程中肝素的应用及患者高血压、动脉硬化、糖尿病等有关,手术是其有效的治疗方法。结论血液透析患者,尤其是合并高血压、动脉硬化、糖尿病的患者不选择直接穿刺动脉作血管通路,首选自体动静脉内瘘,医务人员应掌握其使用时机及穿刺方法,定期的血管通路监测及早期干预,可以减少并发症。假性动脉瘤应早期手术治疗。Objective To analyze the factors related to pseudoaneurysm caused by puncture vascular pathway in hemodialysis patients,and to investigate how to prevent and treat this serious complication in clinic.Methods Retrospective analysis was appliedto analyze the clinical characteristics and the possiblerisk factors for 12 patients with pseudoaneurysm associated with hemodialysis in our hospital.And to further understand the characteristics and treatment of pseudoaneurysms.Results Vascular pathway associated pseudoaneurysms in hemodialysis patients may be relevant to the factors,such as direct puncture artery,puncture failure,non-standard usage of arteriovenous fistula,the application of heparin during dialysis,and patients with hypertension arteriosclerosis or diabetes.Surgery was an effective treatment for those diseases.Conclusion For the patients with hemodialysis,especially patients with hypertensive arteriosclerosis diabetes,the preferred treatment is autogenous arteriovenous fistula,rather than direct puncture artery for vascular access.Pseudoaneurysm should be treated early.To reduce the complications,medical doctors should master the application time and puncture methodwith regular vascular access monitoring and early intervention.

关 键 词：肾透析 动脉瘤 假性 血管 

分 类 号：R692[医药卫生—泌尿科学]