超声引导下置管溶栓联合高压球囊治疗动静脉内瘘急性闭塞的价值分析  

Value of ultrasound-guided in transcatheter thrombolysis combined with high pressure balloon for acute occlusion in arteriovenous fistulas patients

作　　者：陈昶宇[1] 叶鸣[1] 周鸿[1] 刘莹[1] 刘飞 殷俊[2] 崔驰[3] 王弼偲[3] 周洋[1] CHEN Changyu;YE Ming;ZHOU Hong;LIU Ying;LIU Fei;YIN Jun;CUI Chi;WANG Bicai;ZHOU Yang(Department of Ultrasound,the Third people’s Hospital of Chengdu,Chengdu 610031,China)

机构地区：[1]成都市第三人民医院超声科,成都市610031 [2]成都市第三人民医院肾内科,成都市610031 [3]成都市第三人民医院血管外科,成都市610031

出　　处：《临床超声医学杂志》2019年第9期709-711,共3页Journal of Clinical Ultrasound in Medicine

摘　　要：目的探讨超声引导下置管溶栓联合高压球囊治疗动静脉内瘘急性闭塞的临床应用价值。方法选取经超声检查诊断为前臂动静脉内瘘急性闭塞的10例患者(病例组),于超声引导下行置管溶栓联合高压球囊治疗;另选规律血液透析的成熟内瘘并正常使用患者20例为对照组。观察病例组术后1个月、3个月、6个月的内瘘通畅情况,分析病例组术前、术后及与对照组血管内径、峰值流速、肱动脉血流量等的差异。结果病例组10例患者均手术成功,术后1个月、3个月10例患者动静脉内瘘均维持通畅,术后6个月1例患者动静脉内瘘吻合口发生再狭窄;无患者内瘘出现再闭塞。病例组术后狭窄处血管内径和肱动脉血流量均较术前增加,狭窄处峰值流速较术前降低,差异均有统计学意义(均P<0.05);病例组术后各参数与对照组比较差异均无统计学意义。结论超声引导下置管溶栓联合高压球囊可有效治疗前臂动静脉内瘘急性闭塞,具有较好的临床应用价值。Objective To investigate the clinical application value of ultrasound-guided transcatheter thrombolysis combined with high pressure balloon for acute occlusion in arteriovenous fistulas(AVF)patients.Methods Ten patients with acute occlusion of forearm AVF were enrolled in the operation group,and transcatheter thrombolysis with high pressure balloon dilatation were performed under ultrasound guidance.Meanwhile,another 20 patients of mature internal fistula with regular hemodialysis and normal use were selected as control group.The patency rates of AVF at 1,3,6 months after operation were observed.The differences of the vessel internal diameter,the peak systolic velocity(PSV),the blood flow of brachial artery between the pre-operative,the post-operative group and the control group were analyzed and compared.Results All the 10 patients in the postoperative group were successfully operated,no restenosis of AVF was found 1,3 month after operation,and one patient suffered from restenosis of AVF 6 months after operation.No patient suffered from internal fistula and re-occlusion.In the postoperative group,the internal diameter of blood vessels and brachial artery blood flow in the stenosis were increased compared with those before operation,and the peak flow rate in the stenosis was decreased compared with those before operation,with statistically significant differences(all P<0.05).There were no significant difference in parameters between the postoperative group and the control group.Conclusion Ultrasound-guided transcatheter thrombolysis with high pressure balloon is effective to treat acute occlution in forearm AVF patients,with potential clinical application value.

关 键 词：超声引导 动静脉内瘘 闭塞 经皮血管腔内技术 高压球囊 

分 类 号：R445.1[医药卫生—影像医学与核医学]