超声下经皮腔内血管成形术治疗自体动静脉内瘘成熟不良  

Ultrasound guided percutaneous transluminal angioplasty for autogenous arteriovenous fistula maturation failure

作　　者：史珂慧[1] 严森辉 党喜龙 何荃[1] 王萌[1] 刘华[1] 薛瑾虹 魏萌[1] 孙凌霜[1] 陈蕾[1] 刘雯雁[1] 李大庆[1,2] 蒋红利 王瑜[1] SHI Kehui;YAN Senhui;DANG Xilong;HE Quan;WANG Meng;LIU Hua;XUE Jinhong;WEI Meng;SUN Lingshuang;CHEN Lei;LIU Wenyan;LI Daqing;JIANG Hongli;WANG Yu(Department of Severe Nephropathy Blood Purification,The First Affiliated Hospital,Xi’an Jiaotong University,Xi’an 710061,China;Li Daqing Vascular Access Workshop of Baoxiu Doctor Group,Xi’an 710000,China)

机构地区：[1]西安交通大学第一附属医院重症肾脏病·血液净化科,西安710061 [2]葆秀医生集团李大庆血管通路工作室

出　　处：《肾脏病与透析肾移植杂志》2023年第1期21-26,共6页Chinese Journal of Nephrology,Dialysis & Transplantation

基　　金：国家自然科学基金(82170755);陕西省重点研发计划国际科技合作计划项目(2022KW-20)。

摘　　要：目的:分析超声下经皮腔内血管成形术(PTA)治疗自体动静脉内瘘(AVF)成熟不良的临床效果。方法:选取2018年9月至2022年4月在西安交通大学第一附属医院行超声下动静脉内瘘PTA治疗AVF成熟不良的患者,收集基线资料和术前、术后临床资料,观察手术成功率及手术并发症,并用Kaplan-Meier法分析AVF的初级和次级通畅率。结果:408例患者共行722例次PTA,其中AVF成熟不良患者87例。PTA技术成功率和临床成功率分别为98.9%和93.1%,术中、术后无严重并发症。术后AVF中位初次穿刺时间为13(4~21)d。6月、12月和24月AVF的初级通畅率分别为70%、65%和49%,次级通畅率分别为100%、98%和87%。结论:超声下PTA的手术成功率和通畅率均较高,是治疗AVF成熟不良的重要手段。Objective:To retrospectively analyze clinical effect of ultrasound-guided percutaneous transluminal angioplasty(PTA)for autologous arteriovenous fistula(AVF)maturation failure.Methodology:Patients who underwent arteriovenous fistula PTA guided by ultrasound in the First Affiliated Hospital of Xi’an Jiaotong University from September2018 to April 2022 and met the criteria of AVF maturation failure were included.The baseline data,preoperative and postoperative clinical data were collected,the surgical success rate and surgical complications were analyzed,and the primary and secondary patency rates of AVF were evaluated by Kaplan-Meier method.Results:There were 408 patients performed 722 times of PTA,including 87 patients with AVF maturation failure.The technique and clinical success rates of PTA were 98.9%and 93.1%respectively.No serious complications occurred during and after the operation.The median initial puncture time of AVF after PTA was 13(4~21)days.The primary patency rates of AVF at 6,12 and 24 months were 70%,65%and 49%respectively,and the secondary patency rates were 100%,98%and 87%respectively.Conclusion:The success rates and patency rates of ultrasound guided PTA are high,so that it is an important choice for AVF maturation failure.

关 键 词：动静脉内瘘成熟不良 超声下经皮腔内血管成形术 

分 类 号：R445.1[医药卫生—影像医学与核医学] R654.3[医药卫生—诊断学]