彩色多普勒超声引导下动静脉内瘘球囊扩张术在尿毒症维持性血液透析患者中的应用效果  

Application Effects of Color Doppler Flow Imaging Guided Arteriovenous Fistulas Percutaneous Transluminal Angioplasty in Patients with Uremic Maintenance Hemodialysis

作　　者：曲矿云[1] 杨雅丽[1] 秦洋 王慧 鲍旭波 张朝平 QU Kuangyun;YANG Yali;QIN Yang;WANG Hui;BAO Xubo;ZHANG Chaoping(Department of Nephrology,Yellow River Sanmenxia Hospital,Sanmenxia 472000,China)

机构地区：[1]黄河三门峡医院肾内科,河南三门峡472000

出　　处：《河南医学研究》2022年第14期2558-2561,共4页Henan Medical Research

摘　　要：目的探讨彩色多普勒超声(CDFI)引导下动静脉内瘘(AVF)球囊扩张术(PTA)在尿毒症维持性血液透析(MHD)患者治疗中的应用价值。方法选取2018年1月至2021年1月黄河三门峡医院收治的92例尿毒症MHD并发AVF患者作为研究对象,根据手术方法分为常规组(46例)和试验组(46例)。常规组实施传统内瘘切除修复术,试验组实施CDFI引导下AVF PTA术。对比两组内瘘畅通率、手术成功率、手术前后血流情况、术后并发症及再狭窄情况。结果试验组内瘘畅通率[100.00%(46/46)]、手术成功率[97.83%(45/46)]高于常规组[80.43%(37/46)、82.61%(38/46)](P<0.05);试验组血管内径大于常规组,透析血流量、内瘘血流量高于常规组,峰值流速低于常规组(P<0.05);试验组术后并发症发生率[10.86%(5/46)]低于常规组[28.26%(13/46)](P<0.05);术后1个月,两组再狭窄发生率比较,差异无统计学意义(P>0.05);术后6个月,试验组再狭窄发生率[4.34%(2/46)]低于常规组[17.39%(8/46)](P<0.05)。结论采用CDFI引导下AVF PTA治疗尿毒症MHD患者能提高手术成功率,改善血流情况,增加透析效果,减少并发症及再狭窄情况的发生。Objective To explore the application effects of color doppler flow imaging(CDFI)guided arteriovenous fistulas(AVF)percutaneous transluminal angioplasty(PTA)in the treatment of patients with uremic maintenance hemodialysis(MHD).Methods A total of 92 patients with uremic MHD and AVF admitted to Yellow River Sanmenxia Hospital from January 2018 to January 2021 were selected as the research objects.According to surgical methods,they were divided into routine group(46 cases)and experimental group(46 cases).The routine group performed traditional internal fistula resection and repair,and the experimental group performed AVF PTA under the guidance of CDFI.The patency rate of internal fistula,the success rate of operation,blood flow before and after operation,postoperative complications and restenosis were compared between the two groups.Results The patency rate of internal fistula[100.00%(46/46)]and the success rate of operation[97.83%(45/46)]of the experimental group were higher than those[80.43%(37/46),82.61%(38/46)]of the routine group(P<0.05).The blood vessel diameter of the experimental group was larger than that of the routine group,the dialysis blood flow and internal fistula blood flow were higher than those of the routine group,and the peak flow rate was lower than that of the routine group(P<0.05).The postoperative complication rate of the experimental group[10.86%(5/46)]was lower than that[28.26%(13/46)]of the routine group(P<0.05).There was no statistical difference in the incidence of restenosis between the two groups at 1 month after surgery(P>0.05).At 6 months after surgery,the incidence of restenosis of the experimental group[4.34%(2/46)]was lower than that[17.39%(8/46)]of the routine group(P<0.05).Conclusion The use of AVF PTA guided by CDFI to treat patients with uremic MHD can increase the success rate of surgery,improve blood flow,increase the effect of dialysis and reduce the occurrence of complications and restenosis.

关 键 词：尿毒症 维持性血液透析 动静脉内瘘 球囊扩张术 

分 类 号：R692.5[医药卫生—泌尿科学]