经皮腔内血管成形术在血液透析患者动静脉内瘘血管狭窄中的应用

Risk factors of autologous arteriovenous fistula restenosis after percutaneous transluminal angioplasty and re-endovascular treatment for restenosis

目的探讨经皮腔内血管成形术(PTA)在血液透析患者动静脉内瘘血管狭窄中的应用。方法选取徐州医科大学附属宿迁医院/南京鼓楼医院集团宿迁市人民医院2017年6月至2018年09月收治的30例动静脉内瘘狭窄患者。统计30例患者临床基本特征;手术局部的并发症。计算术后180天和360天一期和二期通畅率。结果病变血管长度在术后再狭窄与无再狭窄患者中比较,差异有统计学意义(P<0.05)。非再狭窄患者中,180天一期通畅率为75%,360天为50%;一期中位通畅时间为125.0(93.0,290.0)d。再狭窄患者首次PTA后发生再狭窄的中位时间为104.0(81.3,271.3)d,术后180天累积二期通畅率为86%,360天为86%。二期中位通畅时间为209.0(98.0,370.0)d。结论狭窄病变长度大于5 cm的患者PTA后可能更易发生再狭窄,再狭窄患者给予PTA治疗仍然可以获得较好的临床效果。

Objective To explore the application of percutaneous transluminal angioplasty(PTA)in the treatment of arteriovenous fistula stenosis in hemodialysis patients.Method From June 2017 to September 2018,30 patients with AVF stenosis were selected from The Affiliated Suqian Hospital of Xuzhou Medical University.The basic clinical features and local complications of 30 patients were analyzed.The primary and secondary patency rates were calculated at 180 and 360 days after operation.Result There was a significant difference in the length of diseased vessels between patients with restenosis and those without restenosis(P<0.05).In non restenosis patients,the patency rate was 75%at 180 days and 50%at 360 days,and the median patency time was 125.0(93.0,290.0)days.The median time of restenosis after the first PTA was 104.0(81.3,271.3)days.The cumulative secondary patency rate was 86%in 180 days and 86%in 360 days.The median patency time of the second phase was 209.0(98.0,370.0)days.Conclusion Patients with stenotic lesions greater than 5 cm in length may be more prone to restenosis after PTA,and patients with restenosis can still get better clinical results by PTA treatment.