经皮腔内血管成形术治疗动静脉内瘘狭窄疗效的影响因素

Influencing factors of percutaneous transluminal angioplasty in the treatment of arteriovenous fistula stenosis

目的 探讨超声引导下经皮腔内血管成形术(PTA)治疗动静脉内瘘(AVF)狭窄疗效的影响因素。方法回顾性分析浙江省温州市中西医结合医院2019年2月-2021年3月行超声引导下PTA治疗的85例AVF狭窄患者的临床资料,根据术后12个月AVF通畅率,根据AVF是否通畅分为AVF通畅组50例和AVF不通畅组35例。采用单因素和多因素Logistic回归分析法探讨超声引导下PTA治疗AVF狭窄疗效的影响因素。结果 年龄≥60岁、狭窄长度≥3cm、残留狭窄、糖尿病是超声引导下PTA治疗AVF狭窄疗效的危险因素(OR>1,P<0.05)。结论 年龄、残留狭窄、狭窄长度、糖尿病是超声引导下PTA治疗AVF狭窄疗效的影响因素,临床医生应通过术中减少残留狭窄来减少AVF狭窄的发生。

Objective To study the influencing factors of ultrasound guided percutaneous transluminal angioplasty(PTA)in the treatment of arteriovenous fistula(AVF)stenosis.Methods The clinical data of 85 patients with AVF stenosis who were treated with PTA under guidance from February 2019 to March 2021 in our hospital were analyzed retrospectively.The patency rate of AVF 12 months after operation was calculated.The patients were divided into two groups according to whether AVF was patency.The clinical data of the two groups were compared.The influencing factors of the efficacy of ultrasound guided PTA in the treatment of AVF stenosis were analyzed with multifactor logistic regression analysis.Results In 85 patients,50 patients had AVF patency 12 months after operation,and the patency rate of AVF was 58.82%.Univariate analysis showed that there were significant differences between the two groups in age,AVF stenosis length,residual stenosis,diabetes and other factors(P<0.05).Multivariate logistic regression analysis showed that age≥60 years、stenosis length≥3cm、residual stenosis、diabetes mellitus were the risk factors for the efficacy of ultrasound guided PTA in the treatment of AVF stenosis(OR>1,P<0.05).Conclusion Age、residual stenosis、stenosis length and diabetes mellitus are the influencing factors of the efficacy of ultrasound guided PTA in the treatment of AVF stenosis.Clinical prevention and treatment measures should be formulated according to the above influencing factors to improve the clinical efficacy.