超声引导下活检钳技术在内瘘闭塞中应用的可行性

Feasibility of ultrasound-guided biopsy forceps in the treatment of arteriovenous fistula occlusion

目的探讨超声引导下活检钳咬取闭塞动-静脉内瘘(内瘘)中陈旧性血栓或附壁血栓的可行性及有效性。方法44例行维持性血液透析并内瘘闭塞患者,采用超声引导下活检钳技术取出切开或血管腔内抽吸无法清除的全部血栓,观察其成功率。结果 44例患者中40例成功钳取剩余血栓,成功率为90.91%;4例术前1周内瘘血栓形成、并伴穿刺部位瘤样扩张处附壁血栓形成患者,内瘘未能成功开通,后行对侧肢体自体动-静脉内瘘成形术;均未发生严重并发症。结论维持性血液透析并内瘘闭塞患者切开或血管腔内抽吸无法清除全部血栓时,利用活检钳取栓疗效确切,安全。

Objective To investigate the feasibility and efficacy of ultrasound-guided biopsy forceps on obliterating the old thrombus or mural thrombus in arteriovenous fistula occlusion.Methods Forty-four patients with arteriovenous fistula undergoing maintenance hemodialysis were performed ultrasound-guided biopsy forceps to obliterate all thrombus failed in surgery or percutaneous transluminal angioplasty.The success rate was observed.Results In 44 patients,40 patients(90.91%)were successfully obliterated by biopsy forceps,and the other 4 patients failed due to arteriovenous fistula occlusion and mural thrombus at the dilated puncture site formed one week before operation,which were treated by arteriovenous fistula plasty in the contralateral limb.No serious complications were found.Conclusion Biopsy forceps is effective and safe for patients with arteriovenous fistula occlusion and undergoing maintenance hemodialysis when the thrombus could not be removed by surgery or percutaneous transluminal angioplasty.