超声引导下经皮腔内血管成形术治疗自体动静脉内瘘术后内瘘血管发育不良的疗效观察  

Observe the efficacy of ultrasound-guided percutaneous transluminal angioplasty in the treatment of internal fistula vascular dysplasia after autologous arteriovenous fistula

作　　者：段志强 刘洋 刘奎 芦思好 王朝华 张良 DUAN Zhiqiang;LIU Yang;LIU Kui;LU Sihao;WANG Chaohua;ZHANG Liang(Department of Nephrology,Western Theater Air Force Hospital,Chengdu,Sichuan,610021,China;Department of General Internal Medicine,West China Second University Hospital,Sichuan University,Chengdu,Sichuan,610042,China)

机构地区：[1]西部战区空军医院肾病内科,四川成都610021 [2]四川大学华西第二医院综合内科,四川成都610042

出　　处：《当代医学》2024年第34期138-141,共4页Contemporary Medicine

摘　　要：目的探讨超声引导下经皮腔内血管成形术(percutaneous transluminal angioplasty,PTA)用于治疗自体动静脉内瘘(autologous arteriovenous fistula,AVF)术后内瘘血管发育不良的临床疗效。方法选取2019年3月至2021年11月西部战区空军医院收治的116例AVF术后内瘘血管发育不良患者为研究对象,按照是否行PTA分为观察组(n=84)与对照组(n=32)。对照组采用坚持束臂握拳锻炼,观察组采用超声引导下PTA治疗。分析PTA成功率,比较两组临床有效率、再次手术率及3、6、12个月初级通畅率。结果观察组均成功实施PTA,手术成功率为100.00%;观察组临床有效率为97.62%,高于对照组的43.75%,差异有统计学意义(P<0.05);观察组再次手术率为13.10%,低于对照组的25.00%,但差异无统计学意义;观察组3、6、12个月初级通畅率均高于对照组,差异有统计学意义(P<0.05)。结论超声引导下PTA治疗AVF术后内瘘血管发育不良效果显著,可提高手术成功率、临床有效率及初级通畅率,降低再次手术率。Objective To investigate the clinical efficacy of ultrasound-guided percutaneous transluminal angioplasty(PTA)in the treatment of internal fistula vascular dysplasia after autologous arteriovenous fistula(AVF).Methods A total of 116 patients with internal fistula vascular dysplasia after AVF admitted to the Air Force Hospital of the Western Theater Command from March 2019 to November 2021 were selected as the study subjects,and they were divided into the observation group(n=84)and the control group(n=32)according to whether PTA was performed.The control group was treated with arms binding exercise,and the observation group was treated with ultrasound-guided PTA.The success rate of PTA was analyzed,the clinical effective rate,reoperation rate and the primary patency rate at 3,6 and 12 months were compared between the two groups.Results The PTA was successfully performed in the observation group,the success rate of operation was 100.00%.The clinical effective rate in the observation group was 97.62%,which was higher than 43.75%in the control group,the difference was statistically significant(P<0.05).The reoperation rate in the observation group was 13.10%,which was lower than 25.00%in the control group,but the difference was not statistically significant.The primary patency rate at 3,6 and 12 months in the observation group were higher than that in the control group,and the differences were statistically significant(P<0.05).Conclusion Ultrasound-guided PTA in the treatment of internal fistula vascular dysplasia after AVF has a significant effect,which can improve the success rate of surgery,clinical effective rate and primary patency rate,and reduce the rate of reoperation.

关 键 词：经皮腔内血管成形术 自体动静脉内瘘 发育不良 促成熟 

分 类 号：R47[医药卫生—护理学]