超声引导下球囊扩张在维持性血液透析患者动静脉内瘘狭窄的应用

摘要

目的 探讨超声引导下球囊扩张在维持性血液透析(MHD)患者动静脉内瘘(AVF)狭窄中的应用.方法将78例AVF狭窄的MHD患者随机分为两组,各39例.对照组、观察组分别采用数字减影血管造影(DSA)、彩色多普勒超声(CDFI)引导下球囊扩张.比较两组穿刺成功率、内瘘功能恢复情况及手术并发症发生率.结果 观察组一次穿刺成功率为100.0%,显著高于对照组84.6%( P <0.05);两组术后血管内径、透析血流量均有明显改善,而观察组的改善程度显著优于对照组( P <0.05);观察组手术并发症的总发生率为5.1%,显著低于对照组20.5%( P <0.05).结论 超声引导下球囊扩张治疗MHD 患者AVF 狭窄,可提高穿刺成功率,降低手术并发症,更好地修复内瘘功能.%Objective To explore the application of ultrasound-guided balloon expansion for arteriovenous fistula(AVF) ste-nosis in patients with maintenance hemodialysis(MHD). Methods 78 MHD patients with AVF stenosis were randomly divided into two groups. Control group(n=39) and observation group(n=39) were given digital subtraction angiography(DSA),color doppler flow imaging (CDFI) -guided balloon expansion,respectively. The success rate of puncture, recovery of internal fistula function,and surgical complications beteen two groups were compared. Results The success rate of once puncture in observation group was 100.0%,which was significantly higher than 84.6% of control group( P <0.05). The inner diameter of blood ves-sel,blood flow of dialysis in both groups were improved significantly after surgery,and the improvement in observation group was superior to that in control group ( P <0.05). The total incidence of surgical complications in observation group was 5.1%, which was significantly lower than 20.5% in control group 20.5%( P <0.05). Conclusion Ultrasound-guided balloon expan-sion for AVF stenosis in patients with MHD can improve success rate of puncture,reduce surgical complications,and better repair function of internal fistula.