PTA联合不同支架置入治疗血液透析患者中心静脉狭窄的疗效及其对患者血管通畅情况的影响  

Curative effect of percutaneous transluminal angioplasty combined with different stents implantation in the treatment of central venous stenosis in patients undergoing hemodialysis and their influence on vascular patency

作　　者：郭烁 任莉 GUO Shuo;REN Li(Department of Nephrology,No.215 Hospital of Shaanxi Nuclear Industry,Xianyang 712000,Shaanxi,CHINA)

机构地区：[1]陕西省核工业二一五医院肾内科,陕西咸阳712000

出　　处：《海南医学》2023年第21期3099-3102,共4页Hainan Medical Journal

摘　　要：目的比较经皮腔内血管成形术(PTA)联合不同支架置入治疗血液透析患者中心静脉狭窄(CVS)的疗效及其对患者血管通畅情况的影响。方法前瞻性选取2017年1月至2022年1月陕西省核工业二一五医院收治的60例CVS的血液透析患者为研究对象,采用随机数表法分为A组和B组各30例。A组患者给予PTA联合裸支架置入治疗,B组患者给予PTA联合覆膜支架置入治疗。比较两组患者的手术情况、再狭窄情况以及手术前后的血液透析流量和血管通畅情况。结果A组和B组患者的手术成功率(93.33%vs 100.00%)、临床有效率(90.00%vs 96.67%)及支架置入部位比较差异均无统计学意义(P<0.05);两组患者术后1个月、6个月及1年的血液透析流量均较术前明显升高,且B组患者术后1个月、6个月及1年的血液透析流量分别为(271.20±72.45)mL/min、(253.24±65.77)mL/min、(231.76±52.89)mL/min,明显高于A组的(225.15±80.93)mL/min、(212.32±76.52)mL/min、(200.38±60.43)mL/min,差异均有统计学意义(P<0.05);A组和B组患者术后1个月、3个月和6个月的血管通畅率比较差异均无统计学意义(P>0.05);B组患者术后9个月、1年的血管通畅率分别为83.33%、76.67%,明显高于A组的60.00%、56.67%,差异均有统计学意义(P<0.05);B组患者的术后1年再狭窄率为10.00%,明显低于A组的33.33%,差异有统计学意义(P<0.05)。结论PTA联合裸支架或覆膜支架置入治疗血液透析患者CVS均具有显著疗效,且PTA联合覆膜支架置入更有助于提高患者血液透析流量及血管通畅率,减少再狭窄的发生。Objective To compare the curative effect of percutaneous transluminal angioplasty(PTA)combined with different stents implantation in the treatment of central venous stenosis(CVS)in patients undergoing hemodialysis patients and their influence on vascular patency.Methods Sixty patients undergoing hemodialysis with CVS admitted to No.215 Hospital of Shaanxi Nuclear Industry from January 2017 to January 2022 were prospectively selected as the study objects.They were divided into group A and group B by random number table method,with 30 patients in each group.The patients in the group A were treated with PTA combined with bare stent implantation,and the patients in the group B were treated with PTA combined with coated stent implantation.The surgery situation,restenosis,and hemodialysis flow,vascular patency before and after surgery were compared between the two groups.Results There were no significant differences in surgical success rate(93.33%vs 100.00%),clinical response rate(90.00%vs 96.67%),and stent placement sites between the groups A and B(P>0.05).The hemodialysis flow in the two groups at 1 month,6 months,and 1 year after surgery were significantly higher than those before surgery,and the hemodialysis flow at 1 month,6 months,and 1 year after surgery in the group B were(271.20±72.45)mL/min,(253.24±65.77)mL/min,(231.76±52.89)mL/min,respectively,significantly higher than(225.15±80.93)mL/min,(212.32±76.52)mL/min,(200.38±60.43)mL/min in the group A(P<0.05).There was no significant difference in vascular patency rate between group A and group B at 1 month,3 months,and 6 months after surgery(P>0.05).The vascular patency rate at 9 months and 1 year after surgery in the group B were 83.33%and 76.67%,respectively,which were significantly higher than 60.00%,56.67%in the group A(P<0.05).The restenosis rate at 1 year after surgery in the group B was 10.00%,which was significantly lower than 33.33%in the group A(P<0.05).Conclusion PTA combined with bare stent or covered stent implantation has significant curative e

关 键 词：血液透析 中心静脉狭窄 经皮腔内血管成形术 支架置入 疗效 血管通畅 

分 类 号：R459.5[医药卫生—治疗学]