超声引导下经皮腔内血管成形术治疗动静脉内瘘狭窄的效果研究

Study on the effectiveness of ultrasound-guided percutaneous transluminal angioplasty for the treatment of arteriovenous fistula stenosis

目的研究超声引导下经皮腔内血管成形术治疗动静脉内瘘狭窄的临床效果。方法选取该院2020年1-12月收治的310例血液透析患者进行研究,患者均行超声引导下经皮腔内血管成形术治疗动静脉内瘘狭窄,并且在术前、术后对其狭窄处内径、峰值流速及肱动脉血流量进行测量;术后行超声对治疗效果进行评价,特殊的进行血管造影(CTA)检查。结果经检查310例患者共发现有420处外周血管狭窄。手术后狭窄处内径、峰值流速及肱动脉流量分别为:(3.75±0.42)mm、(220.73±29.16)cm/s、(900.39±130.83)mL/min显著优于术前的[(1.50±0.30)mm、(551.69±96.38)cm/s、(169.74±61.85)mL/min],差异均有统计学意义(P<0.05)。术后有3例特殊患者经CTA检查显示,均存在1~2处中心静脉狭窄。结论超声引导下经皮腔内血管形成术治疗动静脉内瘘狭窄,具有损伤小、术后恢复迅速、操作简单可行的优点。

Objective To analyze the clinical effect of ultrasound-guided percutaneous transluminal angioplasty for the treatment of arteriovenous internal fistula stenosis.Methods A total of 310 hemodialysis patients admitted to the hospital from January 2020 to December 2020 were selected.All patients underwent ultrasound-guided intracavitary angioplasty for the treatment of arteriovenous internal fistula stenosis.The internal diameter of the stenosis,peak flow rate and brachial artery blood flow was measured before and after the procedure.Postoperative ultrasound was performed to evaluate the treatment effect,and special results were examined by CT angiography(CTA).Results A total of 420 peripheral stenoses were identified in 310 patients.The stenosis internal diameter,peak flow velocity and brachial artery flow after surgery were as follows:(3.75±0.42)mm,(220.73±29.16)cm/s,(900.39±130.83)mL/min,significantly better than the preoperative values[(1.50±0.30)mm,(551.69±96.38)cm/s,(169.74±61.85)mL/min],all with statistically significant differences(P<0.05).Postoperatively,three particular patients showed one to two central venous stenoses by CTA.Conclusion Ultrasound-guided percutaneous transluminal angioplasty for arteriovenous fistula stenosis is performed.It has the advantages of minimal injury,rapid postoperative recovery and simple and feasible operation.