覆膜支架在自体动静脉内瘘狭窄治疗中的应用研究  

Application of Stent Graft in the Treatment of Autologous Arteriovenous Fistula Stenosis

作　　者：张宁[1] 田宇 蔡汉鑫 黄智勇 孙丽敏 ZHANG Ning;TIAN Yu;CAI Han-xin(Department of Vascular Surgery,The Third Affiliated Hospital of Shenzhen University,Shenzhen(518000),China)

机构地区：[1]深圳大学第三附属医院血管外科,深圳518000 [2]深圳大学第三附属医院肾内科,深圳518000

出　　处：《中国中西医结合外科杂志》2022年第4期464-467,共4页Chinese Journal of Surgery of Integrated Traditional and Western Medicine

基　　金：深圳市罗湖区软科学研究计划项目(LX20200912)。

摘　　要：目的:评价覆膜支架治疗自体动静脉内瘘(AVF)狭窄的临床疗效。方法:回顾性分析深圳大学第三附属医院2018年1月—2020年10月收治的45例AVF狭窄患者的临床资料,根据手术方式分为两组:覆膜支架组(17例)和球囊扩张组(28例),比较两组患者的临床效果。结果:覆膜支架组的6个月及12个月初级通畅率明显高于球囊扩张组(100.00%vs 78.57%,P=0.040;100.00%vs 64.29%,P=0.005),差异有统计学意义。两组的6个月及12个月次级通畅率差异无统计学意义,两组术后并发症的发生率差异无统计学意义。结论:覆膜支架治疗AVF狭窄与单纯球囊扩张相比,可以明显提高6个月及12个月的初级通畅率,对于反复狭窄的AVF,植入覆膜支架后可明显延长患者的再次干预时间。Objective To evaluate the clinical effectiveness of stent graft versus balloon angioplasty for the treatment of arteriovenous fistula stenosis.Methods The clinical data of 45 patients with AVF stenosis of the third affiliated hospital of Shenzhen University from January 2018 to October 2020 were reviewed.Their clinical manifestations were analyzed.According to the different treatment methods,patients were classified into stent graft(SG)group and percutaneous transluminal angioplasty(PTA)group.The clinical variables were compared between the two groups.Results The primary patency rates of 6 months and 12 months in the SG group were significantly higher than those of PTA group(100.00%vs 78.57%,P=0.040;100.00%vs 64.29%,P=0.005),while the rate of secondary patency have no statistical difference and there is no statistical difference in the incidence of complications and deaths during the perioperative period and 30 days after surgery in the two groups.Conclusion Stent graft is superior to solely percutaneous transluminal angioplasty regarding 6-mouth and 12-month primary patency rate in treating AVF stenosis.For AVF with repeated stenosis,the re-intervention time of patients can be significantly prolonged after implantation of stent graft.

关 键 词：自体动静脉内瘘 覆膜支架 球囊扩张 

分 类 号：R654.4[医药卫生—外科学]