可视化B超引导对经皮球囊扩张血管成形术后动静脉内瘘穿刺的应用

Application of visual B-ultrasound-guided puncture for arteriovenousfistula after percutaneous transluminal angioplasty

目的探讨可视化B超引导下穿刺经皮球囊扩张血管成形术后动静脉内瘘的安全应用效果。方法选取2019年6月至2020年6月在桂林医学院附属医院行规律透析内瘘狭窄行经皮球囊扩张血管成形术后患者120例,随机分成可视化B超引导下穿刺组和常规穿刺组,每组60例。比较两种方法穿刺成功率以及穿刺相关并发症发生率。结果常规穿刺组穿刺成功率低于可视化B超穿刺组(P<0.05)。可视化B超穿刺组穿刺点硬结、穿刺处渗血、皮下血肿的发生率明显低于常规穿刺组(P<0.05)。两组患者均未出现误穿动脉及因穿刺引起的继发感染现象。结论可视化B超引导对经皮球囊扩张血管成形术后动静脉内瘘穿刺效果明显优于常规穿刺组,可以进一步保护扩张术后动静脉内瘘功能,有效预防内瘘穿刺相关的近期部分并发症,提高穿刺安全性,改善尿毒症患者的生活质量,值得临床推广。

Objective To explore the effect of visual B-ultrasound-guided percutaneous balloon dilatation in the treatment of arteriovenous fistula.Methods From June 2019 to June 2020,120 patients with regular dialysis internal fistula stenosis after percutaneous transluminal angioplasty were selected.The patients were randomly divided into two groups:visual B-ultrasound-guided puncture group and conventional puncture group and the success rate and complications of the two groups were compared.Results The success rate of conventional puncture group was lower than that of visual B-ultrasonic puncture group(P<0.05).The complications related to puncture in visual B-ultrasound group were as follows:the incidence of scleroma,blood infiltration and hematoma in the puncture site were significantly lower than that in the routine puncture group(P<0.05).There was no secondary infection caused by wrong puncture of artery and puncture.Conclusions The effect of visual B-ultrasound guidance on the puncture of arteriovenous fistula afterpercutaneous transluminal angioplastywas better than that of the conventional puncture group.It can further protect the function of arteriovenous internal fistula after percutaneous transluminal angioplasty,effectively prevent some recent complications related to internal fistula puncture,and improve the safety of puncture as well as the quality of life of uremic patients,which is worthy of clinical use.