彩超引导下高压球囊治疗在肾透析用自体动静脉内瘘狭窄的效果  

Effect of Color Doppler Ultrasound-guided High Pressure Balloon Therapy on Stenosis of Autogenous Arteriovenous Fistula for Renal Dialysis

作　　者：郭林[1] 贺小霞[1] Guo Lin;He Xiaoxia(Jiaozuo People's Hospital, Jiaozuo Henan 454000, China)

机构地区：[1]焦作市人民医院泌尿内科

出　　处：《临床研究》2019年第8期18-20,共3页Clinical Research

摘　　要：目的分析彩超引导下高压球囊应用在肾透析用自体动静脉内瘘(AVF)狭窄中的价值。方法选择2017年2月-2019年2月焦作市人民医院收治的肾透析用AVF狭窄患者30例作为研究对象,所有患者均经彩超引导下用高压球囊经皮腔内血管成形术(PTA)治疗,评价治疗效果。结果30例患者经PTA治疗成功28例,成功率为93.33%,术后用彩超检查血管狭窄显示明显改善,内瘘处血流显著增加,术后1周均可成功一次肾透析;失败患者2例,主要为导丝难以通过狭窄段,需重建血管通路。30例患者术后仅有1例穿刺部位渗血、1例局部出血形成血肿,对症处理后缓解,并无其他如感染、内瘘血栓形成等并发症发生。结论肾透析用AVF狭窄患者应用超声引导下高压球囊PTA治疗,手术成功率高,可很好地改善患者的血管狭窄与内瘘血流,且并发症少,安全性好,值得在临床应用。Objective To analyze the value of high pressure balloon guided by color Doppler ultrasound in the stenosis of autogenous arteriovenous fistula (AVF) for renal dialysis. Methods Thirty patients with AVF stenosis for renal dialysis admitted to Jiaozuo People's Hospital from February 2017 to February 2019 were selected as the research objects. All patients were treated with high pressure balloon percutaneous transluminal angioplasty (PTA) under the guidance of color Doppler ultrasound, and the therapeutic effect was evaluated. Results Of the 30 patients, 28 were successfully treated with PTA, with a success rate of 93.33%. Color Doppler ultrasonography showed significant improvement in vascular stenosis, significant increase in blood flow at internal fistula, and successful renal dialysis one week after operation. Two patients suffered from failure, mainly because the guidewire was difficult to pass through the stenotic segment and the vascular access needed to be reconstructed. Of the 30 patients, only 1 patient suffered from bleeding at the puncture site and 1 patient suffered from hematoma due to local hemorrhage after operation, which was relieved after symptomatic treatment. No other complications such as infection, internal fistula thrombosis and the like occurred. Conclusion Ultrasound-guided high pressure balloon PTA treatment for renal dialysis patients with AVF stenosis has a high success rate and can improve the blood flow of patients with vascular stenosis and internal fistula, with few complications and high safety. It is worthy of clinical application.

关 键 词：肾透析 自体动静脉内瘘狭窄 超声引导 皮腔内血管成形术 高压球囊 

分 类 号：R445.1[医药卫生—影像医学与核医学]