文章摘要

球囊扩张成形术处理透析用动静脉内瘘狭窄性病变及短中期结果

作者: 1万恒, 1刘灏, 1林智琪, 1陆京伯, 1符方勇, 1黄显莹, 1刘正军
1 南方医科大学南方医院 血管外科，广东 广州 510515
通讯: 刘正军 Email: lzj13802755609@163.com
DOI: 10.3978/.10.3978/j.issn.1005-6947.2016.12.018
基金: 国家临床重点专科建设基金资助项目

摘要

目的：探讨球囊扩张成形技术在治疗血液透析用动静脉内瘘（AVF）狭窄的临床效果。方法：回顾性分析2014年5月—2015年12月间采用球囊扩张成形技术治疗的31例血液透析用AVF狭窄性病变患者的临床资料。结果：31例患者中，男18例，女13例；桡动脉-头静脉内瘘27例，桡动脉-贵要静脉内瘘2例，尺动脉-贵要静脉内瘘2例；均接受球囊扩张技术治疗。28例（90.3%）获得技术上的成功，围手术期无患者死亡。1例患者术后出现动脉穿刺处假性动脉瘤，1例患者术后出现AVF血栓形成，1例患者出现前臂皮下血肿，其他所有患者AVF恢复通畅并能够以正常流量进行血液透析治疗。术后随访3~12个月，3、6、12个月初次通畅率分别为92.9%，75.0%，50.0%。结论：球囊扩张成形术处理AVF狭窄性病变微创、安全，是AVF狭窄性病变的合理治疗方法，但其中长期疗效仍有待于进一步改善。
关键词： 动静脉瘘 缩窄，病理性 扩张术

Balloon dilatation angioplasty for stenosis of hemodialysis arteriovenous fistula and its short- and mid-term results

Authors: 1WAN Heng, 1LIU Hao, 1LIN Zhiqi, 1LU Jingbo, 1FU Fangyong, 1HUANG Xianying, 1LIU Zhengjun
1 Department of Vascular Surgery, Nanfang Hospital, Southern Medical University, Guangzhou 510515, China

CorrespondingAuthor:LIU Zhengjun Email: lzj13802755609@163.com

Abstract

Objective: To investigate the clinical efficacy of balloon dilatation angioplasty in treatment of stenosis of hemodialysis arteriovenous fistula (AVF). Methods: The clinical data of 31 patients undergoing balloon dilatation angioplasty for stenosis of hemodialysis AVF from May 2014 to December 2015 were retrospectively analyzed. Results: Of the 31 patients, 18 cases were male and 13 cases were female; 27 cases had radial artery to cephalic vein AVF, 2 cases had radial artery to basilica vein AVF, and 2 cases had ulnar artery to basilic vein AVF; all cases underwent balloon dilatation angioplasty. Technical success was achieved in 28 patients (90.3%), and no perioperative death occurred. After operation, pseudoaneurysm at puncture site, thrombosis in AVF and forearm hematoma occurred in one case each, and arteriovenous fistula patency was restored which provided normal blood flow for hemodialysis. Postoperative followed-up was conducted for 3 to 12 months, the 3-, 6-, 12-month primary patency rate was 92.9%, 75.0% and 50.0%, respectively. Conclusion: For stenosis of AVF, balloon dilatation angioplasty is minimally invasive and safe, and is a proper treatment method. However, its mid- and long-term efficacy needs further improvement.
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