彩超引导下经皮腔内血管成形术在治疗动静脉内瘘狭窄中的应用  

Application of color ultrasound-guided percutaneous transluminal angioplasty in the treatment of internal arteriovenous fistula stenosis

作　　者：邱创业 李文霞 刘世贞 李杏爱 胡国强[1] QIU Chuangye;LI Wenxia;LIU Shizhen;LI Xingai;HU Guoqiang(Department of Nephrology,Jiangmen Central Hospital,Guangdong,Jiangmen 529000,China;Department of Endocrinology,Jiangmen Central Hospital,Guangdong,Jiangmen 529000,China)

机构地区：[1]广东省江门市中心医院肾内科,广东江门529000 [2]广东省江门市中心医院内分泌科,广东江门529000

出　　处：《中国医药科学》2025年第1期75-78,87,共5页China Medicine And Pharmacy

基　　金：广东省江门市科技计划项目(2022YL01052)。

摘　　要：目的探讨彩超引导下经皮腔内血管成形术(PTA)在血液透析患者自体动静脉内瘘狭窄治疗中的应用及效果。方法选取因自体动静脉内瘘瘘口或瘘口后流出道局限性静脉狭窄,2022年8月至2024年2月在江门市中心医院肾内科行彩超引导下PTA治疗的60例血液透析患者作为研究对象。比较行PTA前后狭窄部位内径、内瘘自然血流量及透析血流量,统计患者术后发生的并发症。结果彩超引导下PTA治疗后狭窄部位内径、血管内自然血流量、透析血流量明显优于术前,差异均有统计学意义(P<0.05)。手术并发症总发生率为10%,其中有5例局部血肿,1例少量附壁血栓。对症处理后均缓解,无血管破裂、感染、症状性肺动脉栓塞等严重并发症。结论彩超引导下PTA治疗自体动静脉内瘘狭窄,不良反应较少,效果较好,安全性较高,术后即可透析。Objective To explore the application and efficacy of color ultrasound-guided percutaneous transluminal angioplasty(PTA)in the treatment of native internal arteriovenous fistula stenosis in hemodialysis patients.Methods A total of 60 hemodialysis patients who underwent color ultrasound-guided PTA treatment due to localized venous stenosis of fistula or outflow tract after fistula of native arteriovenous fistula in the Department of Nephrology,Jiangmen Central Hospital from August 2022 to February 2024 were selected as the study subjects.The inner diameter of the stenosis site,natural blood flow of the fistula,and dialysis blood flow were compared before and after PTA,and the postoperative complications were recorded.Results After color ultrasound-guided PTA treatment,the inner diameter of the stenosis site,natural blood flow in the blood vessels,and dialysis blood flow were significantly better than before surgery,and the differences were statistically significant(P<0.05).The total incidence of surgical complications was 10%.Among the 60 patients,only 5 cases had local hematoma and 1 case had a small amount of mural thrombus,which was relieved after symptomatic treatment.There were no serious complications such as vascular rupture,infection and symptomatic pulmonary embolism.Conclusion Color ultrasound-guided PTA treatment for native arteriovenous fistula stenosis has few adverse reactions,better efficacy,higher safety,and can be d ialyzed after surgery.

关 键 词：透析 内瘘狭窄 彩超 经皮腔内血管成形术 

分 类 号：R459.5[医药卫生—治疗学]