中国血液净化

中国血液净化 ›› 2014, Vol. 13 ›› Issue (01): 49-51.

• 血管通路 • 上一篇    下一篇

球囊血管成形术治疗自体动静脉内瘘相关静脉高压的初步研究

蒋先洪1,文津1,刘新宇2,汤曦3,张任重3,程媛3,付平3,崔天蕾3   

  1. 402160 永川，1 重庆医科大学附属永川医院肾病风湿科
    473009 南阳，2 河南省南阳市中心医院血液净化中心
    610041 成都，3 四川大学华西医院肾脏内科
  • 收稿日期:2013-06-20 修回日期:2013-08-01 出版日期:2014-01-12 发布日期:2014-01-12
  • 通讯作者: 崔天蕾 tianleicui@yeah.net E-mail:tianleicui@163.com

Preliminary study of balloon angioplasty in patients with venous hypertension associated with autogenous arteriovenous fistula.

  • Received:2013-06-20 Revised:2013-08-01 Online:2014-01-12 Published:2014-01-12

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摘要： 目的 前瞻性观察球囊血管成形术(BAP)治疗自体动静脉内瘘相关静脉高压的疗效。方法 2010年6月～2011年12月四川大学华西医院肾脏内科自体动静脉内瘘相关静脉高压患者24例，行BAP治疗者15例，分析其临床特点、病变部位及疗效。 结果 15例患者，男11例，女4例；平均年龄58.24±10.14岁。经血管彩色多普勒检查(CDU)、64排螺旋CT血管成像(CTA)检查发现15例患者均有中心静脉狭窄、闭塞或血栓形成。所有患者均在数字减影血管造影(DSA)引导下于病变部位行BAP治疗，其中13例患者手术成功；2例患者因导丝不能通过闭塞的中心静脉导致BAP未能完成。手术成功的患者术后平均2天症状明显缓解。13例BAP治疗患者均完成随访，随访时间为7～24个月，12例患者临床症状持续缓解，内瘘功能良好，仅1例患者于17个月后出现再狭窄。结论 BAP治疗自体动静脉内瘘相关静脉高压安全且有效，对更远期疗效有待进一步随访。

关键词: 球囊血管成形术, 动静脉内瘘, 并发症, 静脉高压

Abstract: Objective To prospectively evaluate the efficacy of balloon angioplasty(BAP) in patients with venous hypertension associated with autogenous arteriovenous fistula(AVF). Methods 24 patients with venous hypertension associated with AVF were hospitalized between June 2010 and December 2011 in the Department of Nephrology of West China Hospital of Sichuan University. 15 of them who received BAP were recruited. The clinical characteristics, locations of the lesion and therapeutic effects were summarized. Results There were 15 patients (11 males and 4 females) recruited in our study with the mean age of (58.24±10.14) years. Central venous stenosis, obstruction or thrombosis was confirmed in all of them via computerized topographic angiography (CTA) or color Doppler ultrasound (CDU). DSA-guided balloon angioplasty (BAP) were then performed, 13 cases were successful while 2 other cases ended with failure because the guide wires cannot pass through the obstructed central venous. The symptoms were resolved after 2 days on average following BAP. Followed up for 7～24 months, 12 cases maintained clinical remission, and the AVFs were functional. Only one patient got a restenosis after 17 months later. Conclusions The preliminary results demonstrate that BAP for venous hypertension associated with AVF appears to be effective and safe. Further follow-up of patients is required to determine the long-term outcomes.

Key words: Balloon angioplasty, Arteriovenous fistula, Complication, Venous hypertension