摘要
目的探讨分析经皮球囊扩张血管成形术治疗血液透析患者自体动静脉瘘血管狭窄的疗效。方法方便选取该院2016年3月-2019年3月自体动静脉瘘血管狭窄的血液透析患者60例作为研究对象,按照治疗方式的不同将其分为两组,其中采用内口切除重建手术治疗的患者30例作为对照组,采用经皮球囊扩张血管成形术治疗的患者30例作为研究组,比较两组患者手术时间、术中出血量、内瘘血管狭窄改善数、内瘘总通畅时间、内瘘通畅率、治疗前后临床指标改善情况及术后并发症发生情况。结果研究组患者手术时间为(61.41±11.74)min、术中出血量为(131.25±53.36)mL,均少于对照组(73.72±10.38)min、(218.38±65.29)mL,差异有统计学意义(t=4.303、5.660,P<0.05);研究组内瘘血管狭窄改善数为(2.92±1.17)个,显著多于对照组(1.58±0.73)个,差异有统计学意义(t=5.322,P<0.05);研究组狭窄部位血管内径(3.41±0.48)mm、透析血流量(480.47±95.25) mL/min均大于对照组(2.89±0.51)mm、(426.28±86.23)m L/min,差异有统计学意义(t=4.067、2.310,P<0.05);但两组内瘘总通畅时间、通畅率及并发症发生率比较差异无统计学意义(P>0.05)。结论给予血液透析患者自体动静脉瘘血管狭窄时应用经皮球囊扩张血管成形术可有效改善内瘘狭窄情况,安全可靠。
Objective To explore and analyze the effect of percutaneous balloon dilatation angioplasty in the treatment of autologous arteriovenous fistula vascular stenosis in hemodialysis patients.Methods With the approval of the ethics committee,60 patients with autologous arteriovenous fistula vascular stenosis for hemodialysis in the hospital from March2016 to March 2019 were convenient selected as the research objects.They were divided into two groups according to the different treatment methods.Thirty patients treated with resection and reconstruction surgery were used as the control group,and 30 patients treated with percutaneous balloon angioplasty were used as the research group.The operation time,intraoperative blood loss,improvement of internal fistula vascular stenosis and internal fistula were compared between the two groups.Total fistula patency time,internal fistula patency rate,improvement of clinical indicators before and after treatment,and postoperative complications.Results The operation time of the patients in the study group was(61.41±11.74)min,and the intraoperative blood loss was(131.25±53.36)mL,which were less than those in the control group(73.72±10.38)min and(218.38±65.29)m L.The difference was statistically significant(t=4.303,5.660,P<0.05);the number of improvements in fistula vascular stenosis in the study group was(2.92±1.17),which was significantly more than the control group(1.58±0.73),the difference was statistically significant(t=5.322,P<0.05);The inner diameter of the stenosis in the study group was(3.41±0.48)mm and the dialysis blood flow(480.47±95.25)mL/min were greater than those of the control group(2.89±0.51)mm and(426.28±86.23)mL/min,there were differences It was statistically significant(t=4.067,2.310,P<0.05);but there was no significant difference in the total patency time,patency rate and complication rate of internal fistula between the two groups(P>0.05).Conclusion Percutaneous balloon dilatation angioplasty with autologous arteriovenous fistula vascular stenosis in hemodialysis patients can effectively improve the stenosis of internal fistula,and is safe and reliable.
作者
王亮
林海
陈敏
罗滨
黄扬杰
WANG Liang;LIN Hai;CHEN Min;LUO Bin;HUANG Yang-jie(Department of Vascular Surgery,Second Hospital of Sanming City,Fujian Province/The Fifth School of Clinical Medicine,Fujian University of Traditional Chinese Medicine,Sanming,Fujian Province,366000 China)
出处
《中外医疗》
2021年第4期1-4,共4页
China & Foreign Medical Treatment
关键词
经皮球囊扩张血管成形术
血液透析
自体动静脉瘘
血管狭窄
Percutaneous balloon dilatation angioplasty
Hemodialysis
Autogenous arteriovenous fistula
Vascular stenosis
