经皮血管成形术治疗血液透析动静脉内瘘狭窄或闭塞.DOCVIP

腔内血管成型术治疗血液透析动静脉内瘘狭窄25例临床分析 贺 斌，孙 寒，谭隆旺，成友华，俞赶年 （650032昆明，成都军区昆明总医院医学影像科） [摘要] 目的 探讨经皮腔内血管成形术治疗血液透析动静脉内瘘狭窄的临床效果。方法 研究在我院对25例行腔内血管成型术治疗的25例血液透析动静脉内瘘狭窄患者的临床资料进行研究，包括动静脉内瘘狭窄的临床表现、腔内血管成型术治疗方法、治疗前后的血管造影表现、临床效果等资料，并进行分析总结。结果 25例技术和临床成功率均为100%。术后造影显示狭窄血管扩张。术后透析血流量由扩张前（151.43±20.89）ml/min增致（268.38±12.28）ml/min。术中未出现血管破裂、出血及血栓形成等并发症。随访1～16个月，23例患者能维持有效血液透析, 2例患者术后发生再狭窄，行二次治疗。结论 经皮穿刺腔内血管成形术技术成功率高，临床效果满意，可重复性强，是治疗血液透析动静脉内瘘狭窄的首选方法之一。 [关键词] 血液透析；动静脉内瘘；狭窄；腔内血管成形术 [中图法分类号] [文献标志码] A Percutaneous transluminal angioplasty for arteriovenous fistula stenosis in hemodialysis patients: a report of 25 cases He Bin, Sun Han, Tan Longwang Cheng Youhua , Yu Gannian (Department of Medical Imaging, Kunming General Hospital of Chengdu Military Command, Kunming, Yunnan,650032,China) [Abstract] ] Objective Objective To explore the clinical effect of Percutaneous transluminal angioplasty(PTA) for the treatment of arteriovnous fistula stenosis in hemodialysis patients. Methods PTA was performed in 25 hemodialysis patients with arteriovnous fistula stenosis. The clinical presentations of arteriovnous fistula stenosis and the techniques of PTA were summarized. Morever, the preoperative and postoperative angiographic demonstration, and the clinical efficacy of PTA were analyzed. Results The technical and clinical success rate was 100% in 25 cases.The constricted segment was proved to dilate by post-treatment angiography. During the hemodilysi , the volume of blood flow increased from preoperative （151.43±12.28）ml/min to postoperative（268.38±12.28）ml/min. No complications such as vascular perforation, hemorrhage and thrombosis were observed. Followed up from 1 to 16 months, 23 cases finished maintenance hemodialysis. However, recurrent stenosis was found in 2 cases, reopenning with PTA was achieved. Conclusions Conclusions PTA for arteriovnous fistula stenosis has the advantages of high success rate and remarkable effectiveness .Therefore, this meth