透析动静脉内瘘狭窄PTA术后再狭窄应用高压球囊治疗临床研究  

A Clinical Study on the Treatment of Restenosis after PTA Operation in Dialysis Patients with Arteriovenous Fistula Stenosis by High Pressure Balloon

作　　者：杜桂英 李岩岩[1] 程艳[1] 樊一筠 刘冬雨 DU Gui-ying;LI Yan-yan;CHENG Yan;FAN Yi-yun;LIU Dong-yu(Department of Nephrology,The Third People’s Hospital of Zhengzhou,Zhengzhou 450000,Henan Province,China)

机构地区：[1]郑州市第三人民医院肾内科,河南郑州450000

出　　处：《罕少疾病杂志》2024年第12期132-134,共3页Journal of Rare and Uncommon Diseases

基　　金：2024年度郑州市医学科研项目(ZZYK2024025)。

摘　　要：目的探究高压球囊在透析患者动静脉内瘘狭窄行经皮腔内血管成形术(PTA)后再狭窄中的应用价值。方法选取2021年2月至2023年1月我院82例行动静脉内瘘狭窄PTA术后再狭窄患者,电脑随机法分为两组,观察组41例采用高压球囊治疗,对照组41例采用普通球囊治疗。比较两组手术一般情况、手术前后狭窄动静脉血流指标[血管峰值流速、横截面积、阻力指数(RI)]、炎性氧化应激指标[C反应蛋白(CRP)、红细胞分布宽度变异系数(RDW-CV)、超氧化物歧化酶(SOD)、丙二醇(MDA)]、并发症及术后3个月开通率。结果观察组球囊扩张压力高于对照组,球囊扩张次数、住院天数均少于对照组(P<0.05);观察组术后3 d血管峰值流速、RI低于对照组,横截面积大于对照组(P<0.05);术后3 d观察组CRP、RDW-CV、MDA水平低于对照组,SOD水平高于对照组(P<0.05);观察组术后3个月开通率高于对照组(P<0.05);两组并发症发生率间差异无统计学意义(P>0.05)。结论透析患者动静脉内瘘狭窄PTA后再狭窄患者采用高压球囊治疗效果确切,能减少球囊操作次数,提高动静脉开通率,改善狭窄动静脉血流状态,减轻炎性氧化应激反应,促进术后恢复,且具有较高安全性。Objective To investigate the application value of high-pressure balloon in restenosis after percutaneous transluminal angioplasty(PTA)in dialysis patients with arteriovenous fistula stenosis.Methods A total of 82 patients with intravenous fistula stenosis restenosis after PTA operation in our hospital from February 2021 to January 2023 were selected and divided into two groups by computer random method.41 patients in the observation group were treated with high-pressure balloon,and 41 patients in the control group were treated with ordinary balloon.Compare the general conditions of operation of the two groups,as well as blood flow indexes[peak vessel flow rate,cross-sectional area,resistance index(RI)],inflammatory oxidative stress indexes[C-reactive protein(CRP),coefficient of variation of red blood cell distribution width(RDW-CV),superoxide dismutase(SOD),propylene diol(MDA)],complications and 3-month postoperative patency rate before and after surgery.Results The balloon dilation pressure in the observation group was higher than that in the control group,the balloon dilation times and hospitalization days were lower than those in the control group(P<0.05).The peak vascular flow rate and RI in observation group were lower than those in control group at 3 days after operation,and the cross-sectional area was higher than that in control group(P<0.05).The levels of CRP,RDW-CV and MDA in the observation group were lower than those in the control group,and the level of SOD was higher than that in the control group(P<0.05).There was no significant difference in the incidence of complications and the opening rate 3 months after operation between the two groups(P>0.05).Conclusion The effect of high-pressure balloon treatment on patients with PTA after arteriovenous fistula stenosis in dialysis patients is accurate,which can reduce the frequency of balloon operation,improve the blood flow status of stenosis arteriovenous artery,reduce inflammatory oxidative stress response,promote postoperative recovery,and has a high s

关 键 词：动静脉内瘘狭窄 经皮腔内血管成形术 高压球囊 普通球囊 手术成功率 炎性氧化应激 

分 类 号：R543.5[医药卫生—心血管疾病]