中国血液净化

›› 2011, Vol. 10 ›› Issue (9): 479-482.doi: 10.3969/j.issn.1671-4091.2011.09.00

• 临床研究 • 上一篇    下一篇

经皮球囊扩张血管成形术治疗血液透析患者动静脉瘘功能不良

王 鑫 秦 卫 左 力 杨 敏 佟小强 金其庄   

  1. 北京大学第一医院肾内科，北京大学肾脏病研究所，卫生部肾脏疾病重点实验室，北京大学第一医院介入血管外科
  • 收稿日期:2011-05-06 修回日期:1900-01-01 出版日期:2011-09-12 发布日期:2011-09-12
  • 通讯作者: 金其庄

Endovascular salvage of arteriovenous fistula malfunction in hemodialysis patients

WANG Xin, QIN Wei, ZUO Li, YANG Min, TONG Xiaoqiang, JIN Qizhang   

  1. 1Renal Division, Peking University First Hospital; Peking University Institute of Nephrology; Key Laboratory of Renal Disease, Ministry of Health of China; 2Department of Interventional Radiology and Vascular Surgery, Peking University First Hospital, Beijing, China
  • Received:2011-05-06 Revised:1900-01-01 Online:2011-09-12 Published:2011-09-12

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摘要：

目的 观察经皮球囊扩张血管成形术(PTA)治疗血液透析患者动静脉瘘(AVF)功能不良的临床疗效。方法 自2010年1月至12月，对在北京大学第一医院肾内科因AVF功能不良行PTA治疗的患者行前瞻性的临床观察。总结患者的临床特点、血管造影结果和PTA治疗的技术指标、临床和技术成功率。术后对患者进行随访，观察AVF通畅率。结果 12例患者AVF狭窄均发生在吻合口附近，行PTA治疗的技术成功率91.7％(11/12)。7例晚期功能不良病例临床成功率85.7%(6/7)。术后随访8.6(3.3～14.8)个月， AVF1级通畅率为100%。5例AVF早期功能不良患者平均随访8.2(4.1～11.3)个月。1例在PTA术后3个月发生AVF再狭窄，余4例AVF成熟，透析中血流量达200ml/min以上。结论 PTA是治疗血液透析患者AVF功能不良的一个有效手段。

关键词: 经皮球囊扩张血管成形术, 血液透析, 自体动静脉瘘

Abstract:

Objective To investigate the effect of percutaneous transluminal angioplasty (PTA) on autogenous arteriovenous fistula malfunction in hemodialysis patients. Methods A prospective trial was conducted in patients whose arteriovenous fistula (AVF) was salvaged by PTA in our hospital. Results Juxta-anastomosis stenosis was confirmed by fistulogram in 12 AVFs. PTA was performed in 7 AVFs with late malfunction and 5 AVFs with early malfunction. Technical success rate was 91.7%(11/12). In 7 patients with late AVF malfunction, clinical success rate was 85.7% (6/7), and the patients were followed up for 8.6 (3.3～14.8) months. The primary AVF patency rate was 100%. In 5 patients with early AVF malfunction, re-stenosis occurred after 3 months in one patient, and the other 4 AVFs matured eventually. Conclusions PTA successfully improves the fistula patency, and is an effective therapeutic modality for the treatment of AVF malfunction in hemodialysis patients.

Key words: Hemodialysis, Autogenous arteriovenous fistula