经皮球囊扩张血管成形术对血液透析时自体动静脉瘘血管狭窄的疗效及安全性评价

The Efficacy and Safety of Percutaneous Balloon Angioplasty in the Treatment of Arteriovenous Fistula Stenosis during Hemodialysis

目的研究经皮球囊扩张血管成形术对血液透析时自体动静脉瘘血管狭窄的疗效及安全性。方法72例血液透析时自体动静脉瘘血管狭窄患者展开研究,按照简单随机化法进行分组,对照组36例采用内瘘切除重建术,观察组36例实施经皮球囊扩张血管成形术。将两组的治疗效果进行比对。结果两组患者的术后内瘘通畅率、通畅维持时间、并发症发生率差异无统计学意义(P>0.05);观察组患者的内瘘血管狭窄改善个数多于对照组,术后血清单核细胞趋化蛋白-1(MCP-1)、血管内皮生长因子-A(VEGF-A)、静脉压低于对照组,内瘘狭窄部位血管直径、透析血流量大于对照组(P<0.05)。结论对血液透析时自体动静脉瘘血管狭窄患者实施经皮球囊扩张血管成形术具有较高的有效性和安全性。

Objective This paper aims to study the effect and safety of percutaneous balloon angioplasty(PTC)on the stenosis of AVF during hemodialysis.Methods 72 patients with stenosis of AVF were divided into groups by simple randomization,36 cases in the control group were treated with internal fistula resection and reconstruction,and 36 cases in the observation group underwent percutaneous balloon angioplasty.The therapeutic effect of the two groups was compared.Results There was no significant difference in the patency rate,patency maintenance time and complication rate between the two groups(P>0.05).The improvement number of fistula stenosis in the observation group was more than that in the control group,the postoperative serum monocyte chemoattractant protein-1(MCP-1),vascular endothelial growth factor-A(VEGF-A),venous pressure in the observation group were lower than those in the control group,the diameter of fistula stenosis and dialysis blood flow in the observation group were higher than those in the control group(P<0.05).Conclusion Percutaneous balloon angioplasty is effective and safe for patients with arteriovenous fistula stenosis during hemodialysis.