超声引导下经皮静脉球囊扩张术治疗血液透析动静脉内瘘狭窄的临床效果

The Clinical Effect of Ultrasound-Guided Percutaneous Balloon Dilation in the Treatment of Arteriovenous Fistula Stenosis in Patients with Hemodialysis

目的:探析超声引导下经皮静脉球囊扩张术治疗血液透析动静脉内瘘狭窄的临床效果。方法:选取2019年1月~2019年12月中一东北国际医院有限公司诊治的血液透析动静脉内瘘狭窄患者41例为研究对象,患者均接受超声引导下经皮静脉球囊扩张术治疗。回顾性分析患者的临床资料,比较患者治疗前后动静脉内瘘狭窄处内径、血流量及静脉压变化、扩张次数、球囊压力,分析临床疗效、预后效果以及超声检查参数对比。结果:治疗1周后,患者动静脉内瘘狭窄处内径、透析血流量、内瘘自然血流量均明显增加,静脉压下降,差异有统计学意义(P<0.05);患者治疗结果均判定有效,治疗过程中患者均未出现并发症;随访6个月内动静脉内瘘狭窄复发率为2.44%,随访12个月内动静脉内瘘狭窄复发率为9.76%。治疗后,超声检查参数显著改善,与治疗前的各项参数值对比差异明显(P<0.05)。结论:超声引导下经皮静脉球囊扩张术治疗血液透析动静脉内瘘狭窄的临床效果显著,可在超声扫查确认患者动静脉内瘘狭窄位置后,通过物理扩张方式改善动静脉内瘘狭窄情况,且安全性高,但存在一定复发风险,需采取措施改善预后。

Objective:To explore the clinical effect of ultrasound-guided percutaneous balloon dilatation in the treatment of arteriovenous fistula stenosis(AVFS)in patients with hemodialysis.Methods:During from January 2019 to December 2019,a total of 41 patients with AVFS in the Zhongyi Northeast International Hospital were selected as the research subjects.The clinical data of patients were retrospectively analyzed.The changes of internal diameter,blood flow and venous pressure of AVFS before and after treatment were compared,and the clinical efficacy and prognosis and ultrasonography parameter were compared and analyzed.Results:After 1 week of treatment,the internal diameter,dialysis blood flow and natural blood flow of AVFS were significantly increased,and venous pressure was decreased(P<0.05);The results of treatment were all effective,and no complications occurred during the treatment;After 6 months’and 12 months’follow-up,the recurrence rate of AVFS was respectively 2.44%and 9.76%.After treatment,the ultrasound examination parameters were significantly improved,and there was a significant difference compared to the various parameter values before treatment(P<0.05).Conclusion:The clinical effect of ultrasound-guided percutaneous balloon dilatation in the treatment of hemodialysis arteriovenous fistula stenosis is significant.After ultrasound scanning confirmed the location of arteriovenous fistula stenosis,physical expansion can be used to improve the situation of arteriovenous fistula stenosis,and the safety is high,but there is a certain risk of recurrence,and measures should be taken to improve the prognosis.