经皮球囊扩张术治疗血液透析患者动静脉内瘘狭窄或闭塞的临床效果评价  

Clinical evaluation of percutaneous balloon dilatation in the treatment of arteriovenous fistula stenosis or occlusion in hemodialysis patients

作　　者：徐永 谢娟 XU Yong;XIE Juan(Department of Nephrology,Huaian Hospital Affiliated to Xuzhou Medical University,Huaian 223002,China)

机构地区：[1]徐州医科大学附属淮安医院肾脏内科,223002

出　　处：《中国现代药物应用》2022年第22期70-73,共4页Chinese Journal of Modern Drug Application

摘　　要：目的探讨经皮球囊扩张术治疗血液透析患者动静脉内瘘狭窄或闭塞的临床疗效。方法选取60例血液透析动静脉内瘘狭窄或闭塞患者作为研究对象,所有患者均行经皮球囊扩张术治疗。观察比较患者手术前后临床指标(内径狭窄程度、透析血流量、内瘘自然流量)、慢性肾病-矿物质和骨代谢紊乱(CKD-MBD)相关指标[血清甲状旁腺素、血清钙(Ca)、血清磷(P)]达标率、血清白蛋白、超敏C反应蛋白(hs-CRP)水平。结果术后3个月,患者内径狭窄程度0.0(0.0,10.0)%明显低于术前的70.0(70.0,90.0)%,透析血流量250.0(240.0,250.0)ml/min及内瘘自然流量535.0(520.0,550.0)ml/min均高于术前的150.0(150.0,160.0)、320.0(260.0,340.0)ml/min,差异有统计学意义(P<0.05)。患者术后3个月血清Ca、血清P、血清甲状旁腺素达标率分别为85.0%、73.3%、65.0%,均明显高于术前的66.7%、53.3%、46.7%,差异均有统计学意义(P<0.05)。术后3个月,患者的血清白蛋白39.2(36.8,42.2)g/L明显高于术前的37.8(34.1,41.7)g/L,hs-CRP 5.0(2.9,6.7)mg/L明显低于术前的5.0(4.4,16.4)mg/L,差异有统计学意义(P<0.05)。结论经皮球囊扩张术可有效缓解血液透析动静脉内瘘狭窄或闭塞患者的临床症状,改善血清白蛋白水平及CKD-MBD状况,减轻炎症反应。Objective To discuss the clinical efficacy of percutaneous balloon dilatation in the treatment of arteriovenous fistula stenosis or occlusion in hemodialysis patients.Methods A total of 60 cases of hemodialysis patients with arteriovenous fistula stenosis or occlusion were selected as the research subjects,and all patients were treated with percutaneous balloon dilatation.The clinical indexes(degree of internal diameter stenosis,dialysis blood flow,natural flow of internal fistula),chronic kidney disease-mineral and bone metabolism disorder(CKD-MBD)-related indexes[serum parathyroid hormone,serum calcium(Ca),serum phosphorus(P)]attainment rate,serum albumin,and high-sensitivity C-reactive protein(hs-CRP)level before and after the surgery were observed and compared.Results At 3 months after surgery,the degree of inner diameter stenosis 0.0(0.0,10.0)%was significantly lower than 70.0(70.0,90.0)%before surgery;the dialysis blood flow 250.0(240.0,250.0)ml/min and internal fistula natural flow 535.0(520.0,550.0)ml/min were higher than 150.0(150.0,160.0)and 320.0(260.0,340.0)ml/min before surgery;the differences were all statistically significant(P<0.05).At 3 months after surgery,the attainment rates of serum Ca,serum P,and serum parathyroid hormone were 85.0%,73.3%,and 65.0%,which were significantly higher than 66.7%,53.3%,and 46.7%before surgery,and the differences were all statistically significant(P<0.05).At 3 months after surgery,the serum albumin 39.2(36.8,42.2)g/L was significantly higher than 37.8(34.1,41.7)g/L before surgery;the hs-CRP 5.0(2.9,6.7)mg/L was significantly lower than 5.0(4.4,16.4)mg/L before surgery;the differences were all statistically significant(P<0.05).Conclusion Percutaneous balloon dilatation can effectively alleviate the clinical symptoms of patients with arteriovenous fistula stenosis or occlusion,improve the level of albumin and CKD-MBD,and alleviate inflammatory response.

关 键 词：血液透析 动静脉内瘘狭窄或闭塞 经皮球囊扩张术 血清白蛋白 超敏C反应蛋白 

分 类 号：R692.5[医药卫生—泌尿科学]