中国血液净化

中国血液净化 ›› 2018, Vol. 17 ›› Issue (06): 397-400.doi: 10.3969/j.issn.1671-4091.2018.06.009

• 血管通路 • 上一篇    下一篇

超声监测下不同的狭窄阈值对人工血管动静脉内瘘通畅率影响

黄小妹1,王银1,肖伟1,张艺2,高渤3,李晶晶2,江中涛4,叶飞5,马卫国6,钱淑萍7   

  1. 华中科技大学同济医学院附属武汉市中心医院1肾内科2超声影像科
    3湖北中医药大学2016级研究生
    4武汉市新洲区人民医院肾内科
    5湖北航天医院肾内科
    6武汉市江夏区中医院肾内科
    7江汉大学附属第三医院(武汉市黄陂区人民医院)肾内科
  • 收稿日期:2018-01-08 修回日期:2018-03-11 出版日期:2018-06-12 发布日期:2018-06-20
  • 通讯作者: 黄小妹 m18062421823@163.com E-mail:m18062421823@163.com
  • 基金资助:

    本文获得湖北省卫计委科研基金资助，项目编号：WJ2017M185

The effects of stricter stenosis intervention threshold and surveillance by Doppler ultrasound on arteriovenous graft (AVG) patency rate

  • Received:2018-01-08 Revised:2018-03-11 Online:2018-06-12 Published:2018-06-20

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摘要： 【摘要】目的超声监测下将人工血管动静脉内瘘(arteriovenous prosthetic graft,AVG)狭窄干预阈值下调，评估AVG 的次级通畅率及通路结局。方法2011 年6 月～2016 年7 月行AVG 的患者，共26例。A 组：常规干预组12 例，干预标准为显著性狭窄；B 组：下调干预组14 例，在显著性狭窄基础上执行更严格的干预阈值。观察AVG 次级通畅率，血栓事件，年干预次数，通路结局等。结果A、B 组患者基本特征、次级通畅率、血栓事件、通路狭窄部位及次级终点事件无统计学差异。而且，B 组通路干预次数明显低于A 组(0.54±0.34比0.94±0.42，t=2.720，P=0.017)。12 月、24 月及36 月2 组次级通畅率分别为100.0%比100.0%，(68.2± 15.4)%比(78.6±11.0)%，(51.1±18.7)%比(61.1±13.8)% (Log RANK X2=0.007，P=0.941)。结论超声监测下更严格的AVG 干预阈值能降低干预次数，并保持较好的AVG 次级通畅率。

关键词: 人工血管动静脉内瘘（AVG, 血液透析, 临界性狭窄, 显著性狭窄, 次级通畅率, 血栓, 多普勒超声

Abstract: 【Abstract】Objective To evaluate the secondary patency and outcomes of arteriovenous graft (AVG) when stricter stenosis intervention threshold and surveillance by Doppler ultrasound were used. Method A total of 26 patients with AVG and monitored by Doppler ultrasound between June 2011 and July 2016 were enrolled in this study. They were divided into two groups, conventional intervention group (group A, n=12) and stricter stenosis intervention threshold group (group B, n=14). The intervention indication in group B was stricter than that in group A. AVG secondary patency, thrombosis event, intervention frequency per year, and AVG access outcome were compared between the two groups. Results Clinical characteristics, AVG outcomes and thrombosis events were similar between the two groups. However, intervention frequency per year was lower in group B than group A (0.54±0.34 vs. 0.94±0.42, t=2.720, P=0.017). Meanwhile, the secondary patency was similar between the two groups (P=0.941). The secondary patency rates after 12 months, 24months and 36 months were 100% vs. 100%, 68.2±15.4% vs. 78.6±11.0%, and 51.1±18.7% vs. 61.1±13.8% (log rank test, χ2=0.007, P=0.941) in group A and group B, respectively. Conclusions Under ultrasound surveillance, stricter stenosis intervention threshold gets similar AVG secondary patency and reduces intervention frequency per year.

Key words: Arteriovenous Graft, Hemodialysis, Borderline Stenosis, Significant Stenosis, Secondary Patency, Thrombosis, Doppler Ultrasound