经皮球囊血管成形术与经皮支架植入术治疗透析患者中心静脉狭窄的有效性及安全性比较

Comparison of efficacy and safety of percutaneous balloon angioplasty and percutaneous stent implantation in the treatment of central venous stenosis in dialysis patients

目的探讨经皮球囊血管成形术与经皮支架植入术治疗透析患者中心静脉狭窄的有效性及安全性。方法选取2019年1月至2021年1月我院收治的40例中心静脉狭窄的透析患者为研究对象,根据治疗方式不同将其分为A组(24例)和B组(16例)。A组采用经皮球囊血管成形术治疗,B组加以经皮支架植入术治疗。比较两组的治疗效果。结果术后6、12个月,B组的一期通畅率高于A组(P<0.05);B组的每条静脉腔内操作次数多于A组,一期通畅时间短于A组(P<0.05)。术后6、12个月,B组的透析血流量、血管内径大于A组(P<0.05)。术后6、12个月,B组的纤维蛋白原(Fg)、D-二聚体(D-D)水平低于A组(P<0.05)。两组的并发症总发生率无显著差异(P>0.05)。结论在透析患者中心静脉狭窄的治疗中,相较于单纯经皮球囊血管成形术,结合经皮支架植入术有助于提高一期通畅率,促进透析血流量、血管内径及凝血功能改善,且安全性高,值得推广。

Objective To investigate the efficacy and safety of percutaneous balloon angioplasty and percutaneous stent implantation in the treatment of central venous stenosis in dialysis patients.Methods Forty dialysis patients with central venous stenosis admitted in our hospital from January 2019 to January 2021 were selected as the study objects and divided into group A(24 cases)and group B(16 cases)according to different treatment methods.The group A was treated with percutaneous balloon angioplasty,while the group B was added with percutaneous stent implantation.The therapeutic effects of the two groups were compared.Results At 6 and 12 months after operation,the primary patency rate of the group B was higher than that of the group A(P<0.05);the number of operations per venous cavity of the group B was more than that of the group A,and the primary patency time was shorter than that of the group A(P<0.05).At 6 and 12 months after operation,the dialysis blood flow and vascular diameter in the group B were greater than those in the group A(P<0.05).At 6 and 12 months after operation,the levels of fibrinogen(Fg)and D-Dimer(D-D)in the group B were lower than those in the group A There was no significant difference in the total incidence of complications between the two groups(P<0.05).(P>0.05).Conclusion In the treatment of central venous stenosis in dialysis patients,compared to simple percutaneous balloon angioplasty,combined with percutaneous stent implantation can help to improve primary patency rate,promote improvement in dialysis blood flow,vascular diameter and coagulation function,and has high safety,which is worth promoting.