自体动静脉内瘘狭窄患者PTA手术治疗效果及影响因素

Effect of PTA on Stenosis of Autogenous Arteriovenous Fistula and Its Influencing Factors

目的:研究超声引导下经皮腔内血管成形术(PTA)手术治疗自体动静脉内瘘狭窄的效果,对治疗效果的影响因素进行分析。方法:回顾性分析2020年1月-2021年12月于南昌市第一医院接受PTA手术治疗的自体动静脉内瘘狭窄患者资料,总结PTA手术治疗临床效果,并根据治疗效果分为成功组和失败组。记录并对比两组基线资料,回归分析超声引导下PTA手术治疗自体动静脉内瘘狭窄失败的相关影响因素。结果:自体动静脉内瘘狭窄患者超声引导下PTA手术治疗失败率为19.05%;失败组性别、年龄、体重指数、原发病、高胆固醇血症、自体动静脉内瘘位置、狭窄类型、内瘘使用时间、原自体动静脉内瘘术式、发现狭窄至PTA时间、血小板、D-二聚体资料与成功组比较,差异均无统计学意义(P>0.05);失败组高血压患病率、糖尿病患病率、血管钙化发生率均高于成功组,血清超敏C反应蛋白水平高于成功组,差异均有统计学意义(P<0.05);logistic回归分析显示,高血压、糖尿病、血管钙化、超敏C反应蛋白水平高是超声引导下PTA手术治疗自体动静脉内瘘狭窄临床效果的相关影响因素(P<0.05)。结论:超声引导下PTA手术治疗自体动静脉内瘘狭窄存在较高的失败风险,与高血压、糖尿病、血管钙化、超敏C反应蛋白水平高有关。

Objective:To study the effect of percutaneous transluminal angioplasty(PTA)under the guidance of ultrasound in the treatment of stenosis of autogenous arteriovenous fistula,and analyze the influencing factors of the treatment effect.Method:The data of patients with stenosis of autogenous arteriovenous fistula who received PTA surgery in the First Hospital of Nanchang from January 2020 to December 2021 were analyzed retrospectively.The clinical effects of PTA surgery were summarized,and the patients were divided into success group and failure group according to the therapeutic effects.The baseline data of the two groups were recorded and compared,and the related factors influencing the failure of ultrasound guided PTA in the treatment of arteriovenous fistula stenosis were analyzed by regression analysis.Result:The failure rate of PTA under ultrasound guidance was 19.05%.There were no significant differences in sex,age,body mass index,primary disease,hypercholesterolemia,location of autogenous arteriovenous internal fistula,stenosis type,internal fistula use time,original autogenous arteriovenous internal fistula operation style,time from finding stenosis to PTA,platelet,D-dimer between the failure group and the success group(P>0.05).The prevalence of hypertension,diabetes and vascular calcification in the failure group were higher than those in the success group,and the level of serum high-sensitivity C reactive protein was higher than that in the success group,with statistical significance(P<0.05).logistic regression analysis showed that hypertension,diabetes,vascular calcification and high level of high-sensitivity C reactive protein were the relevant influencing factors for the clinical effect of ultrasound-guided PTA in the treatment of arteriovenous fistula stenosis(P<0.05).Conclusion:Ultrasound guided PTA surgery for autogenous arteriovenous fistula stenosis has a high risk of failure,which is related to hypertension,diabetes,vascular calcification,and high level of high-sensitivity C reactive protein.