中国血液净化

中国血液净化 ›› 2019, Vol. 18 ›› Issue (04): 263-265.doi: 10.3969/j.issn.1671-4091.2019.04.014

• 血管通路 • 上一篇    下一篇

经皮球囊扩张成形术治疗慢性人工血管动静脉内瘘闭塞

谭丹1,2,于洋1,崔天蕾1,付平1   

  1. 1.  四川大学华西医院肾脏内科
    2. 四川大学华西临床医学院
  • 收稿日期:2018-08-06 修回日期:2019-02-02 出版日期:2019-04-12 发布日期:2019-04-12
  • 通讯作者: 付平fupinghx@163.com E-mail:fupinghx@vip.163.com

Percutaneous transluminal angioplasty for the treatment of chronic thrombosed arteriovenous graft

  • Received:2018-08-06 Revised:2019-02-02 Online:2019-04-12 Published:2019-04-12

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摘要： 【摘要】目的观察经皮球囊扩张成形术(percutaneous transluminal angioplasty，PTA)治疗慢性人工血管动静脉内瘘(arteriovenous graft,AVG)闭塞疗效。方法回顾性分析四川大学华西医院2017 年1 月～2018 年1 月因AVG 闭塞行PTA 治疗的维持性血液透析患者18 例，分析技术成功率、通畅率、病变特点、并发症。结果本研究共纳入18 例患者，內瘘闭塞时间10.5(3,14)天。静脉吻合口狭窄12例，静脉流出道狭窄7 例，其中狭窄≥2 处者6 例，技术成功率94.4%，并发症发生率5.6%，1 个月、3 个月、6个月及1 年初级通畅率分别是72.2%、66.7%、55.6%和33.3%，次级通畅率分别是88.9%、83.3%、77.8%和50%。结论PTA 治疗慢性AVG 闭塞有效、安全、微创，延长了AVG 使用时间。

关键词: 人工血管动静脉内瘘, 闭塞, 血栓, 经皮球囊扩张成形术, 血液透析

Abstract: 【Abstract】Objective To observe the curative effect of percutaneous transluminal angioplasty (PTA) for the treatment of chronic thrombosed arteriovenous graft (AVG). Methods A retrospective analysis was performed on 18 maintenance hemodialysis patients who underwent PTA for the treatment of chronic thrombosed AVG in West China Hospital of Sichuan University from January 2017 to January 2018. The technical success rate, patency rate, pathological feature and complication of the procedure at different intervals were analyzed. Results A total of 18 patients were enrolled in the study. The occlusion of AVG lasted for 10.5 (3, 14) days. There were 12 cases of venous anastomotic stenosis, 7 cases of venous outflow stenosis, 6 cases had more than 2 stenotic lesions. The technical success rate of the procedure was 94.4% and complication rate was 5.6%. Primary patency after one month, 3 months, 6 months and one year were 72.2%, 66.7%, 55.6% and 33.3% respectively, and secondary patency rates after the same intervals were 88.9%, 83.3%, 77.8% and 50%
respectively. Conclusion PTA is an effective, safe, minimally invasive method for the treatment of chronic thrombosed AVG, with no requirement for the occlusion time. This method prolongs the survival time of arteriovenous graft.

Key words: Arteriovenous graft, Occlusion, Thrombosis, percutaneous transluminal angioplasty, Hemodialysis