高级检索

经皮穿刺腔内血管成形术与开放手术解除Ⅰ型内瘘狭窄的效果比较

李康峰, 汤小芳, 陈欢, 邵泽锋, 严连喜, 张玉强

李康峰, 汤小芳, 陈欢, 邵泽锋, 严连喜, 张玉强. 经皮穿刺腔内血管成形术与开放手术解除Ⅰ型内瘘狭窄的效果比较[J]. 实用临床医药杂志, 2020, 24(23): 21-23. DOI: 10.7619/jcmp.202023007
引用本文: 李康峰, 汤小芳, 陈欢, 邵泽锋, 严连喜, 张玉强. 经皮穿刺腔内血管成形术与开放手术解除Ⅰ型内瘘狭窄的效果比较[J]. 实用临床医药杂志, 2020, 24(23): 21-23. DOI: 10.7619/jcmp.202023007
shu
LI Kangfeng, TANG Xiaofang, CHEN Huan, SHAO Zefeng, YAN Lianxi, ZHANG Yuqiang. A comparative study of percutaneous transluminal angioplasty and open surgery in relieving stenosis of type Ⅰ internal fistula stenosis[J]. Journal of Clinical Medicine in Practice, 2020, 24(23): 21-23. DOI: 10.7619/jcmp.202023007
Citation: LI Kangfeng, TANG Xiaofang, CHEN Huan, SHAO Zefeng, YAN Lianxi, ZHANG Yuqiang. A comparative study of percutaneous transluminal angioplasty and open surgery in relieving stenosis of type Ⅰ internal fistula stenosis[J]. Journal of Clinical Medicine in Practice, 2020, 24(23): 21-23. DOI: 10.7619/jcmp.202023007
shu

经皮穿刺腔内血管成形术与开放手术解除Ⅰ型内瘘狭窄的效果比较

  • 江苏省南京江北人民医院, 1. 肾内科, 2. 介入科, 江苏 南京, 210048;

  • 3. 中国人民解放军海军军医大学附属上海长征医院南京分院 肾内科, 江苏 南京, 210015

详细信息
    通讯作者:

    张玉强, E-mail: zhangyuqiang@medmail.com.cn

  • 中图分类号: R459.5;R543

A comparative study of percutaneous transluminal angioplasty and open surgery in relieving stenosis of type Ⅰ internal fistula stenosis

  • 1. Department of Nephrology, 2. Department of Interventional Medicine, Jiangbei People's Hospital in Nanjing City of Jiangsu Province, Nanjing, Jiangsu, 210048;

  • 3. Department of Nephrology, Nanjing Branch of Shanghai Changzheng Hospital Affiliated to Navy Military Medical University of People's Liberation Army, Nanjing, Jiangsu, 210015

摘要

    摘要
  • 摘要: 目的 比较开放手术与经皮穿刺腔内血管成形术(PTA)解除维持性血液透析(MHD)患者Ⅰ型内瘘狭窄的近期疗效。 方法 将29例MHD期间采用标准自体血管内瘘为血管通路并出现Ⅰ型狭窄的患者随机分为2组。A组(n=15)行PTA解除内瘘狭窄, B组(n=14)行开放手术解除内瘘狭窄。观察术前及术后狭窄处内径及血流量,记录透析前后肌酐、尿素氮水平,计算尿素清除率(URR)以及尿素清除指数(Kt/V)值。 结果 2组术后吻合口内径、内瘘血流量、URR 及Kt/V值与术前比较,差异均有统计学意义(P<0.05或P<0.01); 2组术后以上指标比较,差异无统计学意义(P>0.05)。A组术后半年再狭窄率高于B组,差异有统计学意义(P<0.05)。 结论 PTA与开放手术解除MHD患者Ⅰ型内瘘狭窄的疗效相近。PTA可以节约血管资源,但术后复发率高于开放手术。
    Abstract: Objective To compare the short-term efficacy of open operation and percutaneous transluminal angioplasty(PTA)in relieving type I internal fistula stenosis in maintenance hemodialysis(MHD)patients. Methods A total of 29 MHD patients with type I internal fistula stenosis of vascular access by standard autogenous vascular fistula were randomly divided into two groups. Group A(15 patients)underwent PTA to remove internal fistula stenosis, and group B(14 patients)underwent open surgery to remove internal fistula stenosis. The diameter and blood flow of stenosis fistula were measured before and after operation, creatinine and urea nitrogen levels were recorded before and after dialysis, and urea clearance rate(URR)and urea clearance index(Kt/V)were calculated. Results There were statistically significant intra-group differences in preoperative and postoperative anastomotic diameter, fistula blood flow, URR and Kt/V values(P<0.05 or P<0.01), and no significant between-group differences in the above postoperative indicators were found(P>0.05). The restenosis rate of group A was higher than that of group B, and there was significant difference(P<0.05). Conclusion PTA has similar efficacy but higher postoperative recurrence rate in relieving type I internal fistula stenosis compared with open surgery, and saves vascular resources.
    • HTML全文
    • 参考文献(12)
  • 中国医院协会血液净化中心分会血管通路工作组. 中国血液透析用血管通路专家共识(第2版)[J]. 中国血液净化杂志, 2019, 18(6): 365-381.

    SATO T, TSUBOI M, ONOGI T, et al. Standard procedures of endovascular treatment for vascular access Stenosis in our facility-clinical usefulness of ultrasonography[J]. J Vasc Access, 2015, 16(Suppl 10): S34-S37.

    ANDZIAK P. Ultrasound-guided angioplasty of dialysis fistula – technique description[J]. Pol J Radiol, 2013, 78(4): 56-61.
    李康峰, 周玉坤, 严连喜, 等. 血管扩张器法解除内瘘狭窄的临床疗效观察[J]. 临床肾脏病杂志, 2012, 12(10): 465-467.
    宫峰, 马胜银, 高军. 动静脉内瘘狭窄段切除重建术与经皮腔内血管成形术治疗终末期肾脏病患者自体动静脉内瘘狭窄的疗效比较[J]. 医学临床研究2019, 36(8): 1618-1620.
    徐斌. 动静脉内瘘堵塞是否首选溶栓或介入治疗[J]. 肾脏病与透析肾移植杂志, 2013, 22(2): 143-144.

    REINHOLD C, HAAGE P, HOLLENBECK M, et al. Multidisciplinary management of vascular access for haemodialysis: from the preparation of the initial access to the treatment of stenosis and thrombosis [J]. Vasa, 2011, 40(3): 188-198.

    VACHHARAJANI T J. Diagnosis of arteriovenous fistula dysfunction[J]. Semin Dial, 2012, 25(4): 445-450.
    叶朝阳. 血液透析血管通路技术与临床应用[M]. 第2版. 上海: 复旦大学出版社, 2010: 185-201.

    RAJAN D K, EBNER A, DESAI S B, et al. Percutaneous creation of an arteriovenous fistula for hemodialysis access[J]. J Vasc Interv Radiol, 2015, 26(4): 484-490.

    AYEZ N, FIOOLE B, AARTS R A, et al. Secondary interventions in patients with autologous arteriovenous fistulas strongly improve patency rates[J]. J Vasc Surg, 2011, 54(4): 1095-1099.
    周忠信, 潘春球. 终末期肾病自体动静脉内瘘术后狭窄的手术修复策略[J]. 南方医科大学学报, 2013, 33(10): 1538-1540.
    • 相关文章
    • 施引文献
    • 资源附件(0)
计量
  • 文章访问数:  455
  • HTML全文浏览量:  92
  • PDF下载量:  6
  • 被引次数: 0
出版历程
  • 收稿日期:  2020-10-10
  • 网络出版日期:  2020-12-20

目录

摘要
HTML全文
    参考文献(12)
    相关文章
    施引文献
    资源附件(0)

    /

    返回文章
    返回

    © 2020 《实用临床医药杂志》编辑部

    地址：江苏省扬州市江阳中路136号，扬州大学江阳路北校区14号楼201室邮编：225009电话：0514-87978917、87978989、87978807

    苏公网安备 32100302010246号

    本系统由 北京仁和汇智信息技术有限公司 开发  百度统计