贯穿导丝技术在尿毒症中心静脉闭塞患者中的应用  

The Pull-Through Technique in Endovascular Therapies of Hemodialysis Patients with Central Venous Occlusive Disease

作　　者：徐涛 李楠 杨建勇[3] 黄勇慧[3] XU Tao;LI Nan;YANG Jianyong(Department of Interventional Radiology,Shenzhen People's Hospital,The Second Clinical Medical College,Jinan University,The First Affiliated Hospital,Southern University of Science and Technology,Shenzhen,Guangdong Province 518020,P.R.China)

机构地区：[1]深圳市人民医院暨南大学第二临床医学院南方科技大学第一附属医院介入科,518020 [2]广州市第一人民医院华南理工大学附属第二医院介入放射科,510180 [3]中山大学附属第一医院放射介入科,510080

出　　处：《临床放射学杂志》2022年第4期709-713,共5页Journal of Clinical Radiology

基　　金：广东省自然科学基金项目(编号:2020A1515010920)。

摘　　要：目的 探讨贯穿导丝技术在尿毒症中心静脉闭塞患者中的应用价值。方法 回顾性分析2014年1月至2019年12月诊治的41例中心静脉完全闭塞的尿毒症患者临床资料。所有患者均行腔内介入治疗,术中使用贯穿导丝技术。分析患者手术路径、临床症状改变以及手术成功率。结果 本研究共纳入41例中心静脉闭塞的尿毒症患者,所有患者开通闭塞部位后均成功使用贯穿导丝技术。其中7例患者采用右颈内静脉-股静脉路径,20例患者行右侧肢体内瘘-股静脉路径,14例患者采用左侧肢体内瘘-股静脉路径,术中所有患者均行球囊扩张并支架置入术。术后患者临床症状均明显改善。然而,2例患者术后出现延迟性心包填塞,给予引流后症状好转。结论双入路贯穿导丝技术是一种安全、实用的腔内治疗方法,其能为手术的成功提供重要路径支持,保证了介入手术顺利进行。Objective To investigate the clinical value of pull-through technique in interventional therapy of hemodialysis patients with central venous occlusive disease(CVOD).Methods A retrospective study was conducted on 41 patients with CVOD treated with endovascular therapies using the pull-through technique from Jan 2014 to Dec 2019.Patients’ demographic data,clinical signs and symptoms pre-procedure and post-procedure were followed up and recorded.Results Successful revascularization of CVOD was adopted with pull-through interventional techniques in 41 cases.Among them,the right jugular-femoral vein access was adopted in 7 patients,the right arteriovenous fistula-femoral vein was accessed in 20 patients,and the left fistula-femoral vein was accessed in 14 patients.All patients underwent balloon dilatation and stent deployment during the operation successfully.The related symptoms were improved within 1 day post-procedure.However,two patients suffered from the clinical features of delayed cardiac tamponade on the third-day post treatment,which was confirmed by US and CT.Finally,a pericardial effusion was drained,leading to dramatic improvement in the cardiovascular status of the patients.Conclusion Endovascular revascularization with pull-through technique for CVOD is a safe and practical method,with crucial route support for the success of endovascular therapies.

关 键 词：中心静脉闭塞 腔内治疗 贯穿导丝技术 

分 类 号：R692.5[医药卫生—泌尿科学]