超声引导下经皮腔内血管成形术治疗血液透析患者动静脉内瘘狭窄

Ultrasound-guided percutaneous transluminal angioplasty in the treatment of arteriovenous fistula stenosis in hemodialysis patients

目的:探讨超声引导下经皮腔内血管成形术(percutaneous transluminal angioplasty,PTA)治疗血液透析患者自体动静脉内瘘狭窄的疗效。方法:选取2019年6月—2020年6月因动静脉内瘘术后瘘口或静脉局限性狭窄在汕头大学医学院第一附属医院或汕头潮南民生医院行超声引导PTA治疗的33例血液透析患者,比较手术前后血管狭窄处内径、内瘘自然血流量及透析血流量。结果:超声引导PTA治疗前后血管狭窄处内径分别为(1.49±0.21)mm、(3.90±0.29)mm,内瘘自然血流量分别为(180.69±41.51)mL/min、(587.88±73.96)mL/min,透析血流量分别为(144.73±18.72)mL/min、(290.60±19.64)mL/min,差异均有统计学意义(P<0.001)。结论:超声引导下PTA治疗动静脉内瘘狭窄安全有效,可为长期血液透析患者节约宝贵的血管资源。

Objective:To investigate the efficacy of ultrasound-guided percutaneous transluminal angioplasty(PTA)in the treatment of autologous arteriovenous fistula stenosis in hemodialysis patients.Methods:From June 2019 to June 2020,33 patients who underwent ultrasound-guided PTA treatment at the First Affiliated Hospital of Shantou University Medical College or Shantou Chaonan Minsheng Hospital due to fistula or venous localized stenosis after arteriovenous fistula surgery were selected.The inner diameter of the vascular stenosis,the natural blood flow of the internal fistula,and the blood flow of dialysis before and after operation were compared.Results:Before and after ultrasound-guided PTA treatment,the inner diameters of the vascular stenosis were(1.49±0.21)mm and(3.90±0.29)mm,and the natural blood flow of the internal fistula was(180.69±41.51)mL/min and(587.88±73.96)mL/min,the dialysis blood flow were(144.73±18.72)mL/min and(290.60±19.64)mL/min,respectively,and the differences were statistically significant(P<0.001).Conclusion:Ultrasound-guided PTA is safe and effective in treating arteriovenous fistula stenosis,which can save valuable vascular resources for longterm hemodialysis patients.