欢迎首长视察指导 - 第三军医大学学报.doc

Fogarty球囊导管取栓对人造血管内瘘血栓形成疗效分析 张万君 梅兰 王刚 刘会喜 刘碧坚 蔡宇 贾晓丹 解放军202医院血液净化科，沈阳110003 [摘要] 目的 探讨Fogarty球囊导管取栓术对血液透析患者人造血管内瘘血栓形成的治疗效果。方法 维持性血液透析患者6例，应用Fogarty球囊导管治疗人造血管内瘘血栓形成。在人造血管U形内瘘底部作横切口，选择4F或6F球囊导管由切口插入并越过血栓，向球囊内注入生理盐水，先后将静脉和动脉侧血栓拉出，开放血流，确认内瘘通畅。结果 所有病例血栓均顺利取出，血流通畅。6例中有2例因静脉吻合口狭窄行球囊扩张术，1例存在动脉吻合口狭窄予手术重建。各人造血管内瘘血流量均达到200 ml/min以上，随访中有2例患者分别于取栓后3天和25天再次出现栓塞。 [关键词] Fogarty球囊导管；血栓形成；人造血管内瘘；血液透析 [中图分类号] [文献标志码] [文章编号] Fogarty balloon catheter embolectomy for arteriovenous graft Thrombosis in hemodialysis patients：an analysis of outcomes ZHANG Wanjun*, MEI Lan, WANG Gang, LIU Huixi, LIU Bijian, CAI Yu, JIA Xiaodan Department of Blood Purification, No. 202 Hospital of PLA, Shenyang 110003, Liaoning, China [Abstract] Objective To evaluate the effect of Fogarty balloon catheter embolectomy on arteriovenous graft Thrombosis in hemodialysis patients. Methods Fogarty balloon catheters were applied in 6 cases. The thrombosed graft was incised, a 4 or 6 French catheter was placed in the venous and arterial limbs of the graft respectively, and the Fogarty balloon was passed beyond the thrombus and pulled out after saline was infused into the balloon, the thrombus was taken out. The procedure was considered unsuccessful if the blood flow was not re-established or if the graft rethrombosed within hours. Results The treatment was successfully performed in each patient. Of the 6 cases, 2 cases received balloon dilation for stenosis of venous anastomosis, and 1 case underlying arterial anastomosis lesion received angioplasty. The blood flow of all arteriovenous grafts reached over 200 ml/min, all patients were followed up and 2 grafts rethrombosed in 3 days and 25 days respectively. Conclusion Fogarty balloon catheter embolectomy is effective in restoring patency of thrombosed arteriovenous graft in hemodialysis patients, and more studies are needed. [Key words] fogarty balloon catheter; thrombosis; arteriovenous graft; hemodialysis 近些年，人造血管内瘘在血液透析中的应用越来越多，已经是透析病人血管通路的重要选择之一。人造血管内瘘最常见的并