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| Clinical effects of percutaneous transluminal angioplasty guided by B-ultrasound in treatment of stenosis of autogenous arteriovenous fistula |
| ZHANG Shengze ZHOU Li′na DONG Shaoshao ZHU Yuan WANG Mudan |
| Department of Nephrology, Wenzhou People′s Hospital, Zhejiang Province, Wenzhou 325000, China |
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Abstract Objective To observe the clinical efficacy of percutaneous transluminal angioplasty (PTA) in treatment of patients with autogenous arteriovenous fistula (AVF) under the guidance of B-ultrasound. Methods Thirty cases of AVF stenosis patients with maintenance hemodialysis treated in Wenzhou People′s Hospital from January 2016 to December 2017 were enrolled in the study. All patients were given the percutaneous transluminal angioplasty (PTA) under B-ultrasound. The fistula stenosis vascular diameter (D), cross-sectional area (S), stenosis peak velocity (Vmax), brachial artery resistance index (RI), operation success rate, the postoperative diameter stenosis rate and complications were compared before operation, immediately after operation, and at 1, 3 d after operation. Results Compared with before operation, the D and S of the fistula stenosed vessels were significantly increased (P < 0.05), while the Vmax and brachial artery RI were significantly decreased (P < 0.05), and the D and S of the fistula stenosed vessels at 1, 3 d after operation were significantly higher than those immediately after operation (P < 0.05), while the stenosis site Vmax and brachial artery RI were significantly lower than those immediately after operation (P < 0.05), and there was no significant difference in the D, S, Vmax and brachial artery RI between at 1 d after operation and at 3 d after operation (P > 0.05). The operation success rate was 100.00%, and the total incidence of postoperative complications was 6.67%. The complications were completely subsided after treatment. Conclusion PTA under B-ultrasound for AVF has the features of simple operation and high safety, and it can significantly improve the blood flow velocity and lumen diameter of stenosis site, and enhance the success rate of surgery, therefore it is worthy of clinical promotion.
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[1] 陈敏，赵金文，唐凤英，等.鼻烟窝自体动静脉内瘘在糖尿病肾病中的临床应用[J].医学临床研究，2016，33（5）：939-941.
[2] 卢春苗，林海鸟，黄松完.不同穿刺方向对自体动静脉内瘘的研究[J].中国基层医药，2015，22（2）：317-318.
[3] 熊晓玲，叶有新，李华，等.球囊扩张联合覆膜支架植入治疗人造血管动静脉内瘘狭窄[J].中华肾脏病杂志，2013， 29（7）：498-502.
[4] 中国医院协会血液净化中心管理分会血液净化通路学组.中国血液透析用血管通路专家共识（第1版）[J].中国血液净化，2014，13（8）：549-558.
[5] 徐红艳，王其玉，柯洪丽.钝针扣眼穿刺法在血液透析患者动静脉内瘘保护中的应用[J].蚌埠医学院学报，2014， 39（8）：1150-1152.
[6] 肖友文，潘红霞，鲍永强，等.血液透析患者动静脉内瘘血管壁改变与钙磷代谢的相关性研究[J].西部医学，2017， 29（2）：226-229.
[7] 徐元恺，张丽红，赵艺欣，等.自体动静脉内瘘管径与血管流量参数的相关性分析[J].中华肾脏病杂志，2016，32（7）：494-501.
[8] 薄华颖，张宇虹，礼广森，等.血液透析患者自体动静脉内瘘狭窄处内膜增生的超声评价[J].临床超声医学杂志，2017，19（7）：491-493.
[9] Wakabayashi M，Hanada S，Nakano H，et al. Ultrasound guided endovascular treatment for vascular access malfunction：results in 4896 cases [J]. J Vasc Access，2013，14（3）：225-230.
[10] Gorin DR，Perrino L，Potter DM，et al. Ultrasound-guided angioplasty of autogenous arteriovenous fistulas in the ofhce setting [J]. J Vasc Surg，2012，55（6）：1701-1705.
[11] 卢方平，翁艳.自体动静脉内瘘静脉内膜增生物剥离术前后病理表现[J].中国血液净化，2016，15（6）：338-340.
[12] 谢娟，李正胜，卢晶晶，等.B超引导下经皮血管腔内血管成形术治疗自体动静脉内瘘狭窄12例[J].第三军医大学学报，2017，39（14）：1503-1506.
[13] 黄少敏，岑忠耿，张伟帅，等.彩色多普勒超声评估透析患者动静脉内瘘血栓及狭窄的临床价值[J].中国超声医学杂志，2016，32（1）：31-33.
[14] 徐元恺，张文云，段青青，等.吻合口动脉端狭窄致自体动静脉内瘘早期失功的初步研究[J].中国血液净化，2016， 15（9）：494-497.
[15] 涂波，彭鑫，黄晓玲.超声引导下经皮腔内血管成形术治疗血液透析患者动静脉内瘘狭窄1例[J].临床超声医学杂志，2015，17（5）：329-329.
[16] 姚志敏，申太忠，任建伟，等.经桡动脉行自体动静脉内瘘功能不良的介入治疗[J].中国介入影像与治疗学，2017， 14（2）：65-68.
[17] 张丽红，王玉柱.超声引导PTA在动静脉内瘘狭窄中的应用[J].中国血液净化，2016，15（6）：321-323.
[18] 张树超，胡为民，冯剑，等.超声引导下腔内介入治疗内瘘血管狭窄[J].中国血液净化，2016，15（11）：631-634.
[19] 文玉先，李运梅，李家莲，等.经皮血管腔内球囊扩张术治疗自体动静脉内瘘狭窄的护理[J].护士进修杂志，2017， 32（24）：2279-2281. |
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