小口径动脉患者超声PTA术后内瘘失功影响因素探讨  

Impact Factors of Fistula Failure After Ultrasound-Guided PTA in Patients with Small-Caliber Artery

作　　者：熊智倩 刘俪婷 姜燕 苏朝江 许厅 辜雅静 刘宗旸 XIONG Zhiqian;LIU Liting;JIANG Yan(Guizhou Medical University,Guizhou 550004,China)

机构地区：[1]贵州医科大学临床医学院,贵阳550004 [2]贵州医科大学附属肿瘤医院肾内科,贵阳550003

出　　处：《医学研究杂志》2025年第1期87-91,共5页Journal of Medical Research

基　　金：贵州省卫生健康委员会科学技术基金资助项目(gzwkj2022-325);贵州省科技厅基金资助项目{黔科合成果-LC[2023]021}。

摘　　要：目的 探讨维持性血液透析(maintenance hemodialysis,MHD)小口径动脉患者术前行超声引导下经皮腔内血管成形术(percutaneous transluminal angioplasty,PTA)扩张动脉后建立自体动静脉内瘘(autogenous arteriovenous fistula,AVF)的初级通畅率及影响因素。方法 纳入2019年1月1日~2021年12月31日于贵州医科大学附属肿瘤医院肾内科住院的远端桡动脉直径<1.5mm行超声PTA扩张动脉后建立AVF的终末期肾病血液透析患者128例,依据内瘘通畅性分为失功组和通畅组,观察手术技术成功率、临床成功率、初级通畅率,探讨内瘘失功的影响因素。结果 MHD小口径动脉患者,超声PTA术后建立AVF手术技术成功率为91.4%,临床成功率为83.6%,12个月初级通畅率为54.4%。女性、糖尿病、术前桡动脉直径≤1mm是小口径动脉患者超声PTA术后AVF失功的独立危险因素(P<0.05)。结论 在MHD小口径动脉患者中,PTA扩张动脉后建立AVF的手术技术成功率和初级通畅率较高,糖尿病、女性、术前桡动脉直径≤1.0mm是影响此类患者AVF失功的独立危险因素。Objective To explore the primary patency rate and impact factors of autogenous arteriovenous fistula success after preoperative ultrasound-guided percutaneous transluminal angioplasty(PTA) in patient with small-caliber artery on maintenance hemodialysis(MHD).Methods We included 128 end-stage renal disease patients with distal radial artery diameters <1.5mm,treated with ultrasound-guided percutaneous transluminal angioplasty(PTA) to establish an arteriovenous fistula(AVF) at Guizhou Medical University Affiliated Tumor Hospital between January 1,2019 and December 31,2021.Patients were classified into failure and patency groups based on AVF patency.We assessed the surgical technical success rate,clinical success rate,and primary patency rate,and analyzed factors affecting AVF failure.Results In these patients,the technical success rate of AVF creation after PTA was 91.4%,the clinical success rate was 83.6%,and the 12-month primary patency rate was 54.4%.Female gender,diabetes,and a preoperative radial artery diameter ≤1mm were independent risk factors for AVF failure after PTA(P<0.05).Conclusion Establishing AVF after PTA dilation of arteries in patients with small-caliber arteries undergoing maintenance hemodialysis has a high technical success rate and primary patency rate.Diabetes,female gender,and preoperative radial artery diameter ≤1.0mm are independent risk factors for AVF failure in these patients.

关 键 词：小口径动脉 血液透析 超声PTA 动静脉内瘘 内瘘功能障碍 

分 类 号：R543.5[医药卫生—心血管疾病]