超声引导PTA治疗血液透析动静脉内瘘狭窄治疗中的应用  

Application of Ultrasound Guided PTA in the Treatment of Hemodialysis Arteriovenous Fistula Stenosis

作　　者：张玲[1] 陈明喆[2] 王志芳 李益明 陈健[2] 姜金孝 ZHANG Ling;CHEN Mingzhe;WANG Zhifang(Cheung Kong University affiliated Huanggang City Center Hospital,Huanggang,438000)

机构地区：[1]长江大学附属黄冈市中心医院,黄冈438000 [2]湖北省鄂东医疗集团黄石市中心医院肾内科,黄石435002

出　　处：《中国中西医结合肾病杂志》2022年第4期309-312,共4页Chinese Journal of Integrated Traditional and Western Nephrology

基　　金：湖北省卫生健康委2019年度第三批联合基金面上项目(No.WJ2019H456)。

摘　　要：目的:观察超声引导经皮血管腔内血管成形术(PTA)治疗在血液透析动静脉内瘘狭窄治疗中的应用效果。方法:选取2018年02月—2020年10月我院收治的动静脉内瘘狭窄患者95例,按照随机数字表法分为对照组(n=45)和研究组(n=50)。对照组患者在数字减影血管造影(DSA)下行PTA,观察组患者在超声引导下行PTA。比较两组患者穿刺时间、手术时间、一次穿刺成功率、手术成功率、手术前后血管内径变化及透析血流量情况,统计术后并发症发生情况。结果:研究组穿刺时间和手术时间均较对照组短,差异有统计学意义(P<0.05)。研究组一次穿刺成功率100.00%高于对照组84.44%,差异有统计学意义(P<0.05);研究组手术成功率98.00%较对照组93.33%高,但两组比较差异无统计学意义(P>0.05)。术前两组患者血管内径及透析血流量对比差异无统计学意义(P>0.05);研究组术后血管内径和透析血流量均显著高于对照组,差异有统计学意义(P<0.05)。研究组并发症发生率6.00%显著低于对照组22.22%,差异有统计学意义(P<0.05)。结论:超声引导下PTA在血液透析动静脉内瘘狭窄治疗中应用价值较高,可有效解除内瘘狭窄,实现血管再造,且还能降低并发症发生率,值得临床推广。Objective:To observe the effect of ultrasound-guided percutaneous transluminal angioplasty(PTA) in the treatment of hemodialysis arteriovenous fistula stenosis.Methods:A total of 95 patients with arteriovenous fistula stenosis admitted to our hospital from February 2018 to October 2020 were selected and divided into control group(n=45) and study group(n=50) according to the random number table method.Patients in the control group underwent PTA under digital subtraction angiography(DSA),and patients in the observation group underwent PTA under ultrasound guidance.Puncture time,operation time,one-time puncture success rate,surgical success rate,changes in blood vessel diameter before and after surgery,and dialysis blood flow were compared between the two groups of patients,and postoperative complications were recorded.Results:The puncture time and the operation time of the study group were shorter than those of the control group(P<0.05).The one-time puncture success rate in the study group was higher than that of the control group(100.00% vs.84.44%,P<0.05).The surgical success rate of the study group was higher than the control group(98.00% vs.93.33%,P>0.05).There was no significant difference in vascular diameter and dialysis blood flow between the two groups before operation(P>0.05);postoperative vascular diameter and dialysis blood flow in the study group were significantly higher than those in the control group(P<0.05).The complication rate of the study group was significantly lower than that of the control group(6.00% vs.22.22%,P<0.05).Conclusion:Ultrasound-guided PTA has high application value in the treatment of hemodialysis arteriovenous fistula stenosis,which can effectively relieve the fistula stenosis,realize vascular remodeling,and can reduce the incidence of complications.It is worthy of clinical promotion.

关 键 词：动静脉内瘘狭窄 血液透析 超声引导 PTA 

分 类 号：R692.5[医药卫生—泌尿科学]