超声引导下经皮血管成形术治疗血透患者动静脉内瘘狭窄的疗效分析  

Clinical Effect Analysis of Ultrasound-guided Percutaneous Transluminal Angioplasty For Arteriovenous Fistula Stenosis in Hemodialysis Patients

作　　者：刘威[1] 高占辉[2] 朱润章 滕王成 龚海[1] 吕献军[3] 姚志勇[1] Liu Wei;Gao Zhanhui;Zhu Runzhang;Teng Wanghai;Gong Hai;Lü Xianjun;Yao Zhiyong(Department of Ultrasound,Nanjing BenQ Medical Center,The Affiliated BenQ Hospital of Nanjing Medical University,Nanjing,Jiangsu 210019,China;Nephrology,Nanjing BenQ Medical Center,The Affiliated BenQ Hospital of Nanjing Medical University,Nanjing,Jiangsu 210019,China;Department of Interventional,Nanjing BenQ Medical Center,The Affiliated BenQ Hospital of Nanjing Medical University,Nanjing,Jiangsu 210019,China)

机构地区：[1]南京医科大学附属明基医院超声科,南京市210019 [2]南京医科大学附属明基医院肾脏内科,南京市210019 [3]南京医科大学附属明基医院介入科,南京市210019

出　　处：《中国超声医学杂志》2021年第2期210-213,共4页Chinese Journal of Ultrasound in Medicine

基　　金：南京市科委(No.201803063)。

摘　　要：目的比较并探讨超声引导相对于数字减影技术(DSA)引导经皮腔内血管成形术(PTA)在血透患者动静脉内瘘狭窄诊治中的应用价值。方法对在超声或DSA引导下的PTA治疗动静脉内瘘狭窄手术共80例进行数据分析,其中超声引导(研究组)58例,DSA引导(对照组)22例,比较两种引导方式下一次穿刺成功率、即刻手术成功率、手术前后血管内径、术后血流量以及中位复发时间。结果超声引导下PTA在一次穿刺成功率、手术后血管内径、术后血流量、中位复发时间上优于DSA引导下PTA,两者差异具有统计学意义(P<0.05);即刻手术成功率无统计学差异。结论超声可作为PTA手术治疗内瘘血管狭窄的首选引导手段。Objective To summarize and discuss the application value of Percutaneous transluminal angioplasty(PTA)guided by Ultrasound of Digital subtraction angiography(DSA)in the diagnosis and treatment of arteriovenous fistula stenosis in patients with hemodialysis.Methods In PTA treatment guided by ultrasound or DSA arteriovenous internal fistula stenosis surgery,a total of 80 patients with data analysis,among whom 58 cases(research group)guided by ultrasound and 22 cases(control group)guided by DSA,and comparing the success rate of puncture,immediate success rate of surgery,blood vessel diameter before and after surgery,postoperative blood flow,and the median time to relapse of two guided ways.Results Ultrasound-guided PTA was superior to DSA guided PTA in the success rate of first puncture,vascular diameter after surgery,postoperative blood flow,and median recurrence time,with statistically significant differences(P<0.05).There was no statistical difference in the success rate of immediate operation.Conclusions Ultrasound can be used as the first choice to guide PTA for the treatment of internal fistula stenosis.

关 键 词：超声引导 DSA 内瘘狭窄 经皮腔内血管成形术 

分 类 号：R445.1[医药卫生—影像医学与核医学] R459.5[医药卫生—诊断学]