血液透析患者中心静脉闭塞性疾病手术再通的研究现状  

Surgical recanalization of central venous occlusive diseases in hemodialysis patients:its research status

作　　者：汪汉飞 周石 赵许亚 WANG Hanfei;ZHOU Shi;ZHAO Xuya(School of Medical Imaging,Guizhou Medical University,Guiyang,Guizhou Province 550004,China)

机构地区：[1]贵州医科大学医学影像学院,贵州贵阳550004 [2]贵州医科大学附属医院介入科 [3]贵州医科大学附属肿瘤医院介入科

出　　处：《介入放射学杂志》2024年第10期1138-1141,共4页Journal of Interventional Radiology

摘　　要：血液透析通路是终末期肾病患者的生命线,许多患者依赖该通路进行定期透析,以维持生命。保证通路的长期通畅至关重要,多种因素对通路的通畅性产生影响,如植入支架、电子设备的长期刺激、静脉高压等会导致血管内膜反应性增生,通路出现狭窄或闭塞。目前,维持血液透析通路通畅性的常规方法包括PTA和经皮腔内支架置入术(percutaneous transluminal stenting,PTS)。然而,部分患者的阻塞部分已经完全机化或钙化变硬,常规方法难以实现再通,需要进行锐性穿刺才能再通。该文就血液透析患者中心静脉闭塞性疾病(central venous occlusive diseases,CVOD)手术再通方式进行综述,以期为临床实践提供参考。Hemodialysis access is a lifeline for patients with terminal stage renal disease.Many patients with terminal stage renal disease rely on this access for receiving regular hemodialysis to stay alive.Therefore,it is essential to ensure long-term patency of the access.However,the patency of access can be affected by a lot of factors,such as stent implantation,prolonged irritation from electronic devices,and venous hypertension,all of which can cause reactive endothelial hyperplasia with consequent stenosis or occlusion of the access.Nowadays,the conventional methods to maintain the patency of hemodialysis access include percutaneous transluminal angioplasty(PTA)and percutaneous transluminal stenting(PTS).However,in some patients the tissue of the obstructed site has already been completely organized or has become calcified and hardened.In this case,the recanalization of the obstructed site is difficult to be accomplished by the conventional method,and sharp puncturing is required to achieve effective recanalization of the obstructed site.This paper aims make a comprehensive review concerning the surgical recanalization methods used for central venous occlusive diseases in hemodialysis patients so as to provide useful reference for clinical practice.

关 键 词：血液透析 中心静脉狭窄或闭塞 锐性再通 射频导丝 

分 类 号：R459.5[医药卫生—治疗学]