临床研究(Clinical Research)

介入导管技术在动静脉内瘘失功治疗中的应用

Published at: 2015年第24卷第6期

贺致宾 1 , 张学民 1 , 张小明 1 , 蒋京军 1 , 焦洋 1 , 李清乐 1 , 何长顺 1
1 北京大学人民医院 血管外科,北京 100042
通讯作者 学民 张 Email: zhangxuemin128@126.com
DOI: 10.3978/j.issn.1005-6947.10.3978/j.issn.1005-6947.2015.06.016
基金:

摘要

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

Abstract

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.


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引用

引用本文: 致宾 贺, 学民 张, 小明 张, 京军 蒋, 洋 焦, 清乐 李, 长顺 何. 介入导管技术在动静脉内瘘失功治疗中的应用[J]. 中国普通外科杂志, 2015, 24(6): 847-851.
Cite this article as: HE Zhibin, ZHANG Xuemin, ZHANG Xiaoming, JIANG Jingjun, JIAO Yang, LI Qingle, HE Changshun . Application of interventional catheterization procedure in arteriovenous fistula dysfunction[J]. Chin J Gen Surg, 2015, 24(6): 847-851.