6F儿童导尿管在自体动静脉内瘘急性闭塞中的应用价值  

Application value of 6F children’s catheter in acute occlusion of autogenous arteriovenous fistula

作　　者：尹娜 余文洪 YIN Na;YU Wen-hong(Department of Nephrology,First Affiliated Hospital of Army Medical University,Chongqing 400038,China)

机构地区：[1]陆军军医大学第一附属医院肾科,重庆400038

出　　处：《局解手术学杂志》2021年第9期821-824,共4页Journal of Regional Anatomy and Operative Surgery

摘　　要：目的评价6F儿童导尿管在自体动静脉内瘘(AVF)术后急性血栓导致动静脉内瘘闭塞中的应用价值。方法纳入行AVF术后发生急性血栓导致动静脉内瘘闭塞的终末期肾病(ESRD)患者26例,超声引导下经瘘静脉远心端将6F儿童导尿管球囊末端送至血栓起始段,扩张导尿管球囊后将导尿管往瘘静脉远心端拖移,取出血栓,统计血栓取出情况及AVF再通率,观察肱动脉流量。结果26例患者均在超声引导下使用6F儿童导尿管取出血栓,21例(80.8%)患者血栓完全清除,5例(19.2%)患者血栓少量附壁,术后即时AVF再通率为100%,均能扪及震颤,所有患者术后未出现严重并发症。术后6周,23例患者肱动脉流量大于600 mL/min,AVF流量均能满足血液透析需要。结论超声引导下使用6F儿童导尿管取AVF血栓疗效确切,无明显不良反应。Objective To investigate the application value of 6F children’s catheter in arteriovenous fistula occlusion caused by acute thrombosis after autologous arteriovenous fistula(AVF).Methods A total of 26 patients with end-stage renal disease(ESRD)who suffered arteriovenous fistula occlusion caused by acute thrombosis after AVF were included.Under the guidance of ultrasound,the end of the 6F children’s catheter balloon was sent to the initial segment of thrombus through the distal end of the fistula vein.After the catheter balloon was expanded,the catheter was dragged to the distal end of the fistula vein to remove the thrombus.The removal of thrombus and AVF recanalization rate were counted,and the brachial artery flow was observed.Results The thrombus of all the 26 patients were removed by using 6F children’s catheter under the guidance of ultrasound.The thrombus was completely removed in 21 patients(80.8%)and a small amount of mural thrombi were found in 5 patients(19.2%).The immediate AVF recanalization rate after surgery was 100%,and tremors were palpable.There was no severe postoperative complication occurred in all patients.The brachial artery flow of 23 patients was greater than 600 mL/min,and the AVF flow could meet the needs of hemodialysis 6 weeks after surgery.Conclusion Using 6F children’s catheter to remove AVF thrombus under the guidance of ultrasound has exact curative effect without obvious adverse reactions.

关 键 词：动静脉内瘘闭塞 急性血栓 6F儿童导尿管 溶栓 侧侧吻合 

分 类 号：R619+.2[医药卫生—外科学]