药物涂层球囊和普通球囊在自体动静脉内瘘狭窄中的疗效比较

目的比较药物涂层球囊和普通球囊在自体动静脉内瘘狭窄中的疗效。 方法选择42例自体动静脉内瘘狭窄病人为研究对象，根据治疗方式分为药物涂层球囊组(DCB组)20例和普通球囊组(CB组)22例。DCB组病人采用紫杉醇释放高压分流球囊扩张成形术，CB组病人采用普通球囊扩张成形术。比较2组手术成功率和手术前后狭窄处内径、透析血流量，并比较术后1、6、12个月动静脉内瘘初级通畅率和术后1个月内并发症发生情况。 结果2组手术成功率均为100%。2组病人术前狭窄处内径及透析血流量差异均无统计学意义(P>0.05)；术后2组狭窄处内径及透析血流量均较术前明显改善(P < 0.01)，但2组间差异均无统计学意义(P>0.05)。术后1个月和12个月，2组病人动静脉内瘘初级通畅率差异均无统计学意义(P>0.05)；术后6个月，DCB组初级通畅率高于CB组(P < 0.05)。2组病人术后1个月内并发症发生率差异无统计学意义(P>0.05)。 结论与普通球囊血管成形术相比，药物涂层球囊血管成形术在治疗自体动静脉内瘘狭窄病变方面存在一定优势，可作为治疗自体动静脉内瘘狭窄安全、有效的选择之一。

Comparison of drug-coated balloon and common balloon in the treatment of autogenous arteriovenous fistula stenosis

ObjectiveTo compare the efficacy of drug-coated balloon and common balloon in the treatment of autogenous arteriovenous fistula stenosis. MethodsA total of 42 patients with arteriovenous fistula stenosis were selected as the subjects.According to the treatment methods, 42 patients were divided into drug-coated balloon group(DCB group)(n=20) and common balloon group(CB group)(n=22).Patients in DCB group were treated with paclitaxel release high pressure shunt balloon dilatation, while the patients in CB group were treated with common balloon dilatation.The success rate of operation, diameter and dialysis blood flow of stenosis before and after operation, primary patency rate of arteriovenous fistula at 1, 6 and 12 months after operation and complications within one month after operation were compared between the two groups. ResultsThe success rate of operation in both groups was 100%.Before and after operation, the difference of diameter of stenosis and dialysis blood flow between the two groups were not statistically significant(P>0.05).After operation, the internal diameter and dialysis blood flow of the stenosis were significantly improved in the two groups compared with those before operation(P < 0.01), but there was no significant difference between the two groups(P>0.05).At 1 and 12 months after operation, there was no significant difference in the primary patency rate of arteriovenous fistula between the two groups (P>0.05).At 6 months after operation, the primary patency rate in DCB group was higher than that in CB group(P < 0.05).There was no significant difference in the incidence of complications at 1 month after operation between the two groups(P>0.05). ConclusionsDrug coated balloon angioplasty is superior to common balloon angioplasty in the treatment of autogenous arteriovenous fistula stenosis, which can be used as one of the safe and effective option for the treatment of autogenous arteriovenous fistula stenosis.