超声引导下经皮球囊扩张对动静脉内瘘狭窄患者血管狭窄程度、最大透析流量和术后舒适度的影响  

Effect of Ultrasound-guided Percutaneous Balloon Dilation on the Degree of Vascular Stenosis, Maximum Dialysis Flow and Postoperative Comfort in Patients with Arteriovenous Fistula Stenosis

作　　者：丁常春[1] DING Changchun(Department of Nephrology,Mingguang People's Hospital,Mingguang,Anhui 239400,China)

机构地区：[1]明光市人民医院肾内科血透室,安徽明光239400

出　　处：《临床误诊误治》2023年第9期108-111,共4页Clinical Misdiagnosis & Mistherapy

摘　　要：目的 探究超声引导下经皮球囊扩张对动静脉内瘘狭窄患者血管狭窄程度、最大透析流量和术后舒适度的影响。方法 选取2021年1月—2023年1月收治的动静脉内瘘狭窄90例,根据手术方案的不同分为开放手术组43例和介入治疗组47例。开放手术组予外科手术治疗,介入治疗组予超声引导下经皮球囊扩张治疗。比较2组术后1、3、6个月时动静脉内瘘畅通率,术前、术后1个月时血管狭窄处内径、最大透析流量、内瘘自然流量,术前、术后3 d时舒适度,并分析2组术后6个月内并发症发生情况。结果 术后6个月时,介入治疗组动静脉内瘘畅通率高于开放手术组(P<0.05)。术后1个月时,2组血管狭窄处内径较术前增大,最大透析流量、内瘘自然流量均较术前增多,且介入治疗组血管狭窄处内径、最大透析流量、内瘘自然流量均大于或高于开放手术组(P<0.05)。术后3 d时,2组舒适状况量表(GCQ)生理、心理精神、社会文化、环境评分均较术前下降,但介入治疗组GCQ生理、心理精神、社会文化、环境评分均高于开放手术组(P<0.05)。2组术后感染、穿刺部位血肿、出血、皮下气肿发生率比较差异均无统计学意义(P>0.05)。结论 超声引导下经皮球囊扩张更有助于保障动静脉内瘘狭窄患者术后远期畅通率,且可显著改善血管狭窄处内径、最大透析流量、内瘘自然流量,提高术后舒适度,并不会导致术后并发症的增多。Objective To investigate the effects of ultrasound-guided percutaneous balloon dilation on the degree of vascular stenosis,maximum dialysis flow and postoperative comfort in patients with arteriovenous fistula stenosis(AFS).Methods In total,90 patients with AFS admitted from January 2021 to January 2023 were divided into open operation group(n=43)and interventional treatment group(n=47)according to different surgical plans.The open operation group received surgical treatment,and the interventional treatment group received ultrasound-guided percutaneous balloon dilation.The patency rate of arteriovenous fistula at 1,3 and 6 months after surgery,the inner diameter of vascular stenosis at 1 month before surgery and 1 month after surgery,the maximum dialysis flow,the natural flow of internal fistula,and the comfort level before surgery and at 3 days after surgery were compared between the two groups.The incidence of complications within 6 months after surgery were analyzed.Results At 6 months after surgery,the patency rate of arteriovenous fistula in interventional treatment group was higher than that in open operation group(P<0.05).At 1 month after surgery,the inner diameter of vascular stenosis in the two groups increased compared with that before surgery,and the maximum dialysis flow and natural internal fistula flow increased compared with that before surgery,and the above indicators in interventional treatment group were greater or higher than those in open surgery group(P<0.05).At 3 days after surgery,the physiological,psychophysiological,sociocultural and environmental scores in General Comfort Questionnaire(GCQ)of the two groups were lower than those before surgery,but the physiological,psychophysiological,sociocultural and environmental scores in GCQ of the interventional treatment group were higher than those of the open surgery group(P<0.05).There were no significant differences in the incidence of postoperative infection,puncture site hematoma,hemorrhage and subcutaneous emphysema between the two groups(P

关 键 词：肾透析 动静脉内瘘狭窄 超声引导下经皮球囊扩张 内瘘畅通率 透析流量 舒适度 手术后并发症 皮下气肿 

分 类 号：R459.5[医药卫生—治疗学]