经皮腔内血管成形术联合喜辽妥治疗自体动静脉内瘘狭窄的疗效分析  

Efficacy analysis of percutaneous angioplasty combined with hirudoid in stenosis of autogenous arteriovenous fistula

作　　者：朱玉莉[1] 莫永灿 吕欢艳 王金宝 刘伟波[1] ZHU Yu-li;MO Yong-can;LYU Huan-yan(Yingde People's Hospital,Yingde 513000,China)

机构地区：[1]广东省英德市人民医院,513000

出　　处：《中国现代药物应用》2023年第13期135-138,共4页Chinese Journal of Modern Drug Application

基　　金：清远市社会发展领域科技计划项目(项目编号:200804154562122)。

摘　　要：目的分析经皮腔内血管成形术(PTA)联合多磺酸粘多糖乳膏(商品名:喜辽妥)治疗自体动静脉内瘘(AVF)狭窄的临床疗效。方法64例AVF狭窄患者,按照随机法分为研究组和观察组,各32例。研究组采用PTA联合喜辽妥治疗,观察组单纯行PTA治疗。比较两组患者治疗前后血流量水平及术后3、6、9、12个月的AVF通畅率及血栓发生率。结果术后6、9、12个月,研究组AVF血栓发生率分别为9.4%、18.8%、31.3%,低于观察组的31.3%、43.8%、56.3%,差异有统计学意义(P<0.05)。治疗后,研究组血流量(435.69±23.24)ml/min、内瘘口内径(3.69±0.44)mm、内瘘口峰值流速(250.48±25.05)cm/s均优于观察组的(401.46±24.18)ml/min、(3.46±0.18)mm、(265.51±30.03)cm/s,差异均有统计学意义(P<0.05)。两组术后3、6、9、12个月的AVF通畅率比较,差异无统计学意义(P>0.05)。结论PTA联合喜辽妥外敷改善内瘘血流量、改善内瘘功能、降低血栓发生率,延缓内瘘血管的硬化,减少静脉炎的发生率,延长内瘘血管的使用寿命,使透析患者透析更充分,对自体AVF有很好的维护作用,大大提高了患者的透析质量和生活质量,值得临床应用。Objective To analyze the clinical efficacy of percutaneous angioplasty(PTA)combined with mucopolysaccharide polysulfate cream(trade name:Hirudoid)in stenosis of arteriovenous fistula(AVF).Methods A total of 64 patients with AVF stenosis were randomly divided into research group and observation group,with 32 cases in each group.The research group was treated with PTA and Hirudoid,and the observation group was treated with PTA alone.The blood flow level before and after treatment,the AVF patency rate at 3,6,9 and 12 months after surgery and the incidence of thrombosis were compared between the two groups.Results At 3,6,9 and 12 months after surgery,the incidence rates of AVF thrombosis were 9.4%,18.8%and 31.3%in the research group,which were lower than those of 31.3%,43.8%and 56.3%in the observation group,and the difference was statistically significant(P<0.05).After treatment,the research group had blood flow of(435.69±23.24)ml/min,internal diameter of internal fistula of(3.69±0.44)mm and peak velocity of internal fistula of(250.48±25.05)cm/s,which were all better than those of(401.46±24.18)ml/min,(3.46±0.18)mm and(265.51±30.03)cm/s in the observation group,and the differences were statistically significant(P<0.05).There was no statistically significant difference in the AVF patency rate at 3,6,9,12 months after surgery between the two groups(P>0.05).Conclusion PTA combined with Hirudoid can improve the blood flow of internal fistula,improve the function of internal fistula,reduce the incidence of thrombosis,delay the hardening of internal fistula vessels,reduce the incidence of phlebitis,extend the service life of internal fistula vessels,make dialysis more adequate for dialysis patients,has a good maintenance effect on AVF,greatly improve the dialysis quality and quality of life of patients,which is worthy of clinical application.

关 键 词：经皮腔内血管成形术 自体动静脉内瘘 多磺酸粘多糖乳膏 

分 类 号：R692.5[医药卫生—泌尿科学]