外周切割球囊和高压球囊治疗移植物内瘘近静脉吻合口狭窄的临床比较  

Comparison of peripheral cutting balloon and high-pressure balloon in the treatment of venous juxta-anastomotic stenosis in arteriovenous grafts

作　　者：刘文静[1] 陈凯 王宇飞[1] 张倍豪[1] 王欣芳[1] 陆晓青[1] 梁献慧[1] 王沛[1] Liu Wenjing;Chen Kai;Wang Yufei;Zhang Beihao;Wang Xinfang;Lu Xiaoqing;Liang Xianhui;Wang Pei(Blood Purification Center,The First Affiliated Hospital of Zhengzhou University,Zhengzhou 450052,China;Department of Nephrology,Kaifeng People’s Hospital,Kaifeng 475000,China)

机构地区：[1]郑州大学第一附属医院血液净化中心,河南郑州450052 [2]开封市人民医院肾内科,河南开封475002

出　　处：《中国血管外科杂志（电子版）》2024年第2期139-143,共5页Chinese Journal of Vascular Surgery(Electronic Version)

基　　金：国家自然科学基金面上项目(82370747);开封市科技发展计划项目(2207003)。

摘　　要：目的比较外周切割球囊(peripheral cutting balloon,PCB)和高压球囊(high-pressure balloon,HPB)治疗移植物内瘘近静脉吻合口狭窄的疗效与安全性。方法回顾性收集郑州大学第一附属医院血液净化中心2017年3月至2022年3月行经皮腔内血管成形术治疗移植物内瘘近静脉吻合口狭窄的63例患者(184例次)临床资料,并根据应用球囊类型分为PCB组(84例次)和HPB组(100例次),比较两组的手术成功率、即刻管腔获得及通畅情况。结果PCB组干预后靶病变的中位一期通畅时间显著优于HPB组[212(117,353)d比178(113,292)d,P=0.016],手术即刻管腔获得也显著高于HPB组[(2.72±0.84)mm比(2.28±0.77)mm,P<0.001]。PCB组术后半年和1年的一期通畅率分别为60.6%和23.2%,均优于HPB组的49.9%和11.6%,但差异均无统计学意义(P>0.05)。PCB的靶病变标化干预率为1.59次/患者年,低于HPB组的2.10次/患者年,下降32.1%。结论相比于HPB,PCB可延长人工血管动静脉内瘘近静脉吻合口狭窄的干预后靶病变一期通畅时间,降低靶病变的干预频率。Objective To compare the efficacy and safety of peripheral cutting balloon(PCB)and high-pressure balloon(HPB)angioplasty in the treatment of venous juxta-anastomotic stenosis in arteriovenous grafts.Methods The clinical data of 63 patients(184 times)of percutaneous transluminal angioplasty for the treatment of venous juxta-anastomotic stenosis in arteriovenous grafts in the Blood Purification Center of the First Affiliated Hospital of Zhengzhou University from March 2017 to March 2022 were collected retrospectively and analyzed according to the type of balloon used.The patients were divided into PCB group(84 cases)and HPB group(100 cases)according to the types of balloon used.The surgical success rate,immediate lumen gain and primary patency of the two groups were compared.Results The median primary patency time of the target lesion after intervention in the PCB group was significantly better than that in the HPB group[212(117,353)days vs 178(113,292)days,P=0.016],and the immediate lumen gain after surgery was also significantly higher than in the HPB group(2.72±0.84 mm vs 2.28±0.77 mm,P<0.001).The primary patency rates of the PCB group six months and one year after surgery were 60.6%and 23.2%respectively,which were both better than the HPB group’s 49.9%and 11.6%,but the differences were not statistically significant(P>0.05).The target disease standardized intervention rate of PCB was 1.59 times per patient-year,which was lower than the 2.10 times per patient-year of the HPB group,a decrease of 32.1%.Conclusion Compared with HPB,the application of PCB can prolong the primary patency time of target lesions after intervention for venous juxta-anastomotic stenosis in arteriovenous grafts and reduce the frequency of target lesion intervention.

关 键 词：移植物内瘘 静脉吻合口狭窄 经皮腔内血管成形术 外周切割球囊 高压球囊 

分 类 号：R459.5[医药卫生—治疗学]