高压球囊扩张左前臂自体动静脉内瘘狭窄的临床研究  

Clinical study of autogenous arteriovenous fistula stenosis in left forearm with high pressure balloon dilatation

作　　者：廖佳隆 胡荣梅 田云飞[3] Liao Jialong;Hu Rongmei;Tian Yunfei(The People's Hospital of Ningdu County,Ningdu,Jiangxi 342800;The Shishang Central Health Center of Ningdu County,Ningdu,Jiangxi 342802;The People's Hospital of Ganzhou City,Ganzhou,Jiangxi 341000)

机构地区：[1]宁都县人民医院,江西宁都342800 [2]宁都县石上中心卫生院,江西宁都342802 [3]赣州市人民医院,江西赣州341000

出　　处：《基层医学论坛》2020年第35期5041-5042,共2页The Medical Forum

基　　金：赣州市指导性科技计划项目(GZ2018ZSF703)。

摘　　要：目的探讨高压球囊扩张左前臂自体动静脉内瘘狭窄的临床效果。方法选取赣州市人民医院2017年6月—2019年6月收治的30例左前臂自体动静脉内瘘狭窄患者,采用高压球囊进行内瘘狭窄扩张成形术,并对手术平均扩张次数、手术成功率、术后出血率、术后6个月血透通路初级通畅率、术后6个月病死率等进行分析。结果30例前臂AVF狭窄患者高压球囊内瘘狭窄扩张成形术均获得成功,手术成功率100%,术后患者原临床症状均消失,可实施正常血液透析至少1次。球囊的扩张压力介于10~24 atm,平均测验为(15.37±0.83)atm,平均扩张次数为(1.27±0.89)次,30例患者术后未发生破裂出血及>30%残余狭窄病例,均对扩张效果满意。给予全部患者6个月以上随访,平均随访期(8.13±2.29)个月,术后6个月内无死亡病例。术后6个月血透通路的初级通畅率为94.5%。结论高压球囊扩张成形术作为利用自身血管对失功能内瘘修复的一种行之有效的方法,具有较高的即时开通率及可重复性优点,对延长肾功能衰竭患者的生存时间具促进作用。Objective To investigate the clinical effect of autogenous arteriovenous fistula stenosis in left forearm with high pressure balloon dilation.Methods 30 patients with autologous arteriovenous fistula in left forearm admitted to Ganzhou People's Hospital from June 2017 to June 2019 were selected,internal fistula stenosis dilatation was performed with high-pressure balloon,and the effects of average operative dilatation times,operative success rate,postoperative bleeding rate,primary hemodialysis access patency rate 6 months after surgery,and postoperative mortality rate were analyzed.Results All the 30 patients with AVF anterior wall stenosis underwent dilatation angioplasty with high pressure balloon,and the operation success rate was 100%.The original clinical symptoms of the patients disappeared after operation,and normal hemodialysis could be performed at least once.The balloon dilatation pressure was between 10 and 24atm,the average test was(15.37±0.83 ATM),and the average times of dilatation were(1.27±0.89).There were 30 patients with no postoperative rupture hemorrhage and>30%residual stenosis,all of whom were satisfied with the dilatation effect.All patients were followed up for more than 6 months,with an average follow-up period of(8.13±2.29)months.There was no death in the 6 months after the operation.The primary patency rate of hemodialysis was 94.5%6 months after operation.Conclusion As an effective method to repair dysfunctional internal fistula with autovascular,high-pressure balloon dilatation angioplasty has the advantages of high immediate opening rate and repeatability,and can promote the survival time of patients with renal failure.

关 键 词：血液透析 左前臂 自体动静脉内瘘狭窄 高压球囊扩张成形术 

分 类 号：R692.5[医药卫生—泌尿科学]