摘要
目的分析超声引导下经皮腔内血管成形术(PTA)治疗慢性肾衰竭患者动静脉内瘘狭窄疗效的影响因素。方法发生动静脉内瘘狭窄的慢性肾衰竭患者80例均接受超声引导下PTA手术治疗,统计患者手术成功率和术后血管通畅率,比较手术前后患者血管内径、血管内血流量、穿刺针血流量。根据术后12个月血管通畅率,将患者分为观察组(血管不通畅)和对照组(血管通畅),分析影响慢性肾衰竭伴动静脉内瘘狭窄患者超声引导下PTA手术效果的因素。结果80例患者手术成功率为92.50%,术后1、3、6、12个月血管通畅率分别为95.00%、90.00%、72.50%、56.25%,术后患者血管内径、血管内血流量、穿刺针血流量均改善(P<0.05)。年龄≥60岁、BMI≥25 kg/m2、高血压、高血糖、高血脂、血尿酸≥360μmol/L、吸烟史是影响慢性肾衰竭伴动静脉内瘘狭窄患者超声引导下PTA手术效果的危险因素(P<0.05)。结论超声引导下PTA手术治疗慢性肾衰竭伴动静脉内瘘狭窄,可有效缓解血管狭窄状况;但术后受多种因素影响易再次发生血管狭窄,需要密切监测和预防。
Objective To analyze the factors influencing the therapeutic effect of ultrasound-guided percutaneous transluminal angioplasty(PTA)in the chronic renal failure(CRF)patients with arteriovenous fistula stenosis.Methods Ultrasound-guided PTA was conducted in 80 CRF patients with arteriovenous fistula stenosis.The surgical success rate and postoperative vascular patency rate were counted.The blood vessel diameter,blood flow inside and blood flow of puncture needle were compared before and after operation.According to the rate of vascular patency 12 months after operation,80 cases were divided into two groups of A(without vascular patency)and B(with vascular patency).The factors influencing the effect of ultrasound-guided PTA in CRF patients with arteriovenous fistula stenosis were analyzed.Results The surgical success rate of 80 cases was 92.50%and the vascular patency rates for the 1st,3rd,6th and 12th month after surgery were 95.00%,90.00%,72.50%and 56.25%,respectively.The postoperative vascular diameter,blood flow inside and blood flow of puncture needle were all improved(P<0.05).Age≥60 years old,BMI≥25 kg/m2,hypertension,hyperglycemia,hyperlipidemia,blood uric acid≥360μmol/L,and smoking history were the risk factors influencing the effect of ultrasound-guided PTA surgery in CRF patients with arteriovenous fistula stenosis(P<0.05).Conclusion Ultrasound-guided PTA surgery for CRF patients with arteriovenous fistula stenosis can effectively improve the condition of vascular stenosis.Vascular stenosis is easily to occur again under the influence of a variety of postoperative factors and close monitoring and prevention are needed.
作者
高婉仪
曾永威
陈思念
GAO Wanyi;ZENG Yongwei;CHEN Sinian(Department of Ultrasonography,Foshan Sanshui District People's Hospital,Foshan 528100,CHINA)
出处
《江苏医药》
CAS
2020年第12期1267-1270,共4页
Jiangsu Medical Journal
基金
佛山市医学类科技攻关项目(1920001000429)。
关键词
经皮腔内血管成形术
动静脉内瘘
慢性肾衰竭
超声
Percutaneous transluminal angioplasty
Arteriovenous fistula stenosis
Chronic renal failure
Ultrasound
