超声引导下经皮腔内血管成形术治疗动静脉内瘘狭窄的临床价值研究  

Clinical value of ultrasound-guided percutaneous transluminal angioplasty in the treatment of arteriovenous fistula stenosis

作　　者：梁英级 吴静 赵星卫 马春成 黄淑卿 钟逢逍 LIANG Ying-ji;WU Jing;ZHAO Xing-wei(Ulurasonography Department,Wuyi Hospital of Traditional Chinese Medicine,Jiangmen 529000,China)

机构地区：[1]广东省江门市五邑中医院超声科,529000

出　　处：《中国实用医药》2020年第35期21-23,共3页China Practical Medicine

基　　金：江门市科技计划项目(项目编号:2019020400880004473)。

摘　　要：目的探讨超声引导下经皮腔内血管成形术(PTA)治疗动静脉内瘘狭窄的临床价值。方法 40例维持性规律血液透析患者,所有患者均在超声引导下行PTA治疗动静脉内瘘狭窄。比较所有患者、临床成功患者手术前后内瘘血管狭窄处内径、内瘘血管狭窄处流速峰值、肱动脉阻力指数(RI)、肱动脉血流量。结果 40例患者技术成功率为92.5%(37/40),临床成功率为90.0%(36/40)。术后发生血栓形成2例、血管塌陷回缩1例、血管破裂1例。所有患者术前内瘘血管狭窄处内径(1.56±0.24)mm、内瘘血管狭窄处流速峰值(477.54±54.00)cm/s、肱动脉RI(0.63±0.09)、肱动脉血流量(216.58±43.88)ml/min与术后的(3.40±0.92)mm、(263.70±97.51)cm/s、(0.53±0.09)、(526.68±137.86)ml/min比较,差异均有统计学意义(P<0.05)。临床成功患者术前内瘘血管狭窄处内径(1.58±0.24)mm、内瘘血管狭窄处流速峰值(482.05±52.67)cm/s、肱动脉RI(0.63±0.10)、肱动脉血流量(215.08±45.18)ml/min与术后的(3.66±0.30)mm、(259.86±68.26)cm/s、(0.52±0.25)、(563.47±82.87)ml/min比较,差异均有统计学意义(P<0.05)。结论超声引导下行PTA治疗动静脉内瘘狭窄患者,可有效维持外周血管通路通畅,具有安全性,值得临床推广应用。Objective To discuss the clinical value of ultrasound-guided percutaneous transluminal angioplasty(PTA)in the treatment of arteriovenous fistula stenosis.Methods There were 40 cases of maintenance regular hemodialysis patients,and all patients underwent ultrasound-guided PTA to treat arteriovenous fistula stenosis.The internal diameter of the stenosis of the internal fistula vessel,the peak flow velocity at the stenosis of the internal fistula,RI of the brachial artery,and the blood flow of the brachial artery before and after the surgery of all patients and clinically successful patients were compared.Results The technical success rate was 92.5%(37/40)and the clinical success rate was 90.0%(36/40).There were 2 cases of thrombosis,1 case of vessel collapse and retraction and 1 case of vessel rupture after the surgery.In all patients,the internal diameter of the stenosis of the internal fistula vessel(1.56±0.24)mm,the peak flow velocity at the stenosis of the internal fistula(477.54±54.00)cm/s,RI of the brachial artery(0.63±0.09),and the blood flow of the brachial artery(216.58±43.88)ml/min before the surgery had statistically significant difference compared with(3.40±0.92)mm,(263.70±97.51)cm/s,(0.53±0.09)and(526.68±137.86)ml/min after the surgery(P<0.05).In clinically successful patients,the internal diameter of the stenosis of the internal fistula vessel(1.58±0.24)mm,the peak flow velocity at the stenosis of the internal fistula(482.05±52.67)cm/s,RI of the brachial artery(0.63±0.10),and the blood flow of the brachial artery(215.08±45.18)ml/min before the surgery had statistically significant difference compared with(3.66±0.30)mm,(259.86±68.26)cm/s,(0.52±0.25)and(563.47±82.87)ml/min after the surgery(P<0.05).Conclusion Ultrasound-guided PTA for patients with arteriovenous fistula stenosis can effectively maintain the patency of peripheral vascular access with high safety,and is worthy of clinical promotion and application.

关 键 词：动静脉内瘘狭窄 经皮腔内血管成形术 超声引导 内瘘狭窄 

分 类 号：R654.4[医药卫生—外科学]