目的：探讨动静脉内瘘（AVF）失功后介入手术的治疗方法，评估其治疗效果及应用价值。方法：回顾性分析自2006 年4 月—2015 年1 月行介入手术治疗的20 例自体AVF 失功患者的临床资料。结果：20 例患者中，16 例经静脉端造影，4 例经股动脉- 主动脉- 腋动脉路径造影；单纯吻合口狭窄4 例，行球囊扩张后狭窄明显改善；吻合口狭窄伴血栓形成有5 例，切开取栓后再行球囊扩张治疗；静脉端血栓形成3 例，切开取栓后返血良好；静脉端狭窄合并血栓形成7 例，行切开取栓后再行球囊扩张治疗；头静脉长段闭塞1 例，改用人工血管行AVF 术。术后全部患者经该血管通路恢复透析治疗，透析时流量均>200 mL/min。共17 例患者获得随访，平均随访时间13.2 个月，12 个月通畅率为47.1%。结论：介入导管技术在治疗AVF 失功方面是安全、有效的。
Application of interventional catheterization procedure in arteriovenous fistula dysfunction
Objective: To investigate the interventional surgery for arteriovenous fistula (AVF) dysfunction and evaluate its therapeutic effect and application value. Methods: The clinical data of 20 patients with autogenous AVF dysfunction undergoing interventional treatment from April 2006 to January 2015 were retrospectively reviewed. Results: Among the 20 patients, 16 cases underwent angiography through venous approach, and 4 cases had angiography through femoral/aortic/axillary artery approach; 4 cases had simple anastomotic stenosis that was significantly improved by balloon dilatation, 5 cases had anastomotic stenosis with thrombosis, which was treated by balloon expansion after venous embolectomy; 3 cases had thrombosis at the venous anastomotic site, and good backflow was obtained after embolectomy; 7 cases with venous anastomotic stenosis and thrombosis underwent balloon angioplasty after venous embolectomy, and one case with long segment stenosis of the cephalic vein was treated by inserting a prosthetic arteriovenous graft. All patients restarted dialysis treatment using the original vascular access, with dialysis flow greater than 200 mL/min. Follow-up was obtained in 17 patients, with an average follow-up period of 13.2 months, and the 12-month patency rate was 47.1%. Conclusion: Interventional catheterization procedure is safe and effective in treatment of AVF dysfunction.