血液透析患者肱动脉假性动脉瘤的诊治体会  

Diagnosis and treatment of brachial artery pseudoaneurysm in hemodialysis patients

作　　者：温静 詹申 王玉柱[1] Wen Jing;Zhan Shen;Wang Yu-zhu(Department of Nephrology,Haidian Hospital,Peking University Third Hospital,Beijing 100080,China)

机构地区：[1]北京市海淀医院(北京大学第三医院海淀院区)肾内科,北京100080

出　　处：《临床肾脏病杂志》2023年第1期12-17,共6页Journal Of Clinical Nephrology

摘　　要：目的 总结血液透析患者出现肱动脉假性动脉瘤的治疗方法及经验。方法 回顾性分析2014年7月至2021年7月北京市海淀医院肾内科收治的19例因肱动脉假性动脉瘤入院的血液透析患者的临床资料。结果 共收治肱动脉假性动脉瘤患者19例,明确与透析穿刺相关者14例,1例患者保守治疗,12例患者行介入下支架置入术,4例患者行杂交手术,2例患者行超声引导下局部凝血酶注射,随访时间1~49个月,1例患者术后1个月内死亡,原因不详,其余患者肱动脉均连续通畅。结论 对于血液透析患者出现肱动脉假性动脉瘤,应当及早发现,及时处理。可根据破口大小、瘤体特点、并发症的情况选择不同手术方式,尽快解决出血,保留动脉的连续性,避免出现严重并发症。Objective To summarize the treatments and experiences of brachial artery pseudoaneurysm in hemodialysis patients.Methods From July 2014 to July 2021,clinical data were retrospectively reviewed for 19 hemodialysis patients with brachial artery pseudoaneurysm.Results Among them, 14 cases were identified as related to dialysis puncture.One case was treated conservatively, 12 cases received interventional stent implantation, 4 cases underwent hybrid surgery and 2 cases received ultrasound-guided local thrombin injection.Follow-up period was(1-49) months.One patient died within 1 month after surgery, and the cause was unknown.Brachial artery was continuously unobstructed in other cases.Conclusion Brachial artery pseudoaneurysm in hemodialysis patients should be detected and treated as soon as possible.Different surgical options may be selected according to size of rupture, tumor characteristics and complications.Arresting hemorrhage as soon as possible, preserving arterial continuity and avoiding serious complications are essentials.

关 键 词：动静脉内瘘 血液透析 肱动脉 假性动脉瘤 

分 类 号：R692.5[医药卫生—泌尿科学]