经皮球囊扩张血管成形术(PTA)治疗血液透析患者动静脉内瘘狭窄的有效性评价

Evaluation of the Effectiveness of Percutaneous Balloon Angioplasty(PTA)in the Treatment of Arteriovenous Fistula Stenosis in Hemodialysis Patients

目的分析经皮球囊扩张血管成形术(percutaneous transluminal sngioplasty,PTA)治疗血液透析(haemo‐dialysis,HD)患者动静脉内瘘狭窄的临床效果。方法选择徐州市矿山医院2021年1月—2023年1月间肾内科收治的70例血液透析动静脉内瘘狭窄患者资料,以随机数表法分为两组,采取内瘘重建术治疗的35例划分为对照组,采取经皮球囊扩张血管成形术治疗的35例划分为观察组。对比两组手术相关指标、再狭窄发生率、并发症发生率及动静脉内瘘狭窄改善情况。结果术后观察组内瘘狭窄处内径、肱动脉血流量、泵控血流量均高于对照组,峰值流速低于对照组,差异有统计学意义(P<0.05)。观察组再狭窄发生率为2.86%,较对照组的22.86%更低,差异有统计学意义(χ^(2)=4.590,P<0.05)。观察组并发症发生率为5.71%,较对照组22.86%更低,差异有统计学意义(χ^(2)=4.200,P<0.05)。两组术后内瘘通畅率均为100.00%,观察组内瘘血管狭窄改善个数高于对照组,差异有统计学意义(P<0.05)。结论PTA治疗HD患者动静脉内瘘狭窄效果显著,可有效改善患者血流参数,并减少并发症,预防再狭窄发生,有效改善患者动静脉内瘘狭窄情况。

Objective To analyze the clinical effect of percutaneous balloon angioplasty(PTA)in the treatment of arteriovenous fistula stenosis in hemodialysis(HD)patients.Methods The data of 70 patients with hemodialysis arteriovenous fistula stenosis admitted to the Department of Nephrology in Xuzhou Mining Hospital from January 2021 to January 2023 were selected.The patients were divided into two groups using the random number table method.35 cases treated with internal fistula reconstruction were divided into the control group,and 35 cases treated with percutaneous balloon dilatation angioplasty were divided into the observation group.The surgery-related indicators,restenosis rate,complication rate and improvement of arteriovenous fistula stenosis were compared between the two groups.Results After surgery,the inner diameter of the internal fistula stenosis,brachial artery blood flow,and pump-controlled blood flow in the observation group were higher than those in the control group,and the peak flow velocity was lower than that in the control group,and the difference was statistically significant(P<0.05).The incidence rate of restenosis in the observation group was 2.86%,which was lower than 22.86% in the control group,and the difference was statistically significant(χ^(2)=4.590,P<0.05).The incidence rate of complications in the observation group was 5.71%,which was lower than 22.86% in the control group,and the difference was statistically significant(χ^(2)=4.200,P<0.05).The postoperative fistula patency rate in both groups was 100.00%,the number of improvements in fistula vascular stenosis in the observation group was higher than that in the control group,and the difference was statistically significant(P<0.05).Conclusion PTA has a significant effect in treating arteriovenous fistula stenosis in HD patients.It can effectively improve the patient's blood flow parameters,reduce complications,prevent restenosis,and effectively improve the condition of arteriovenous fistula stenosis in patients.