Fogarty球囊导管治疗血液透析患者动静脉内瘘血管栓塞的远期疗效观察

目的 观察应用Fogarty球囊取栓导管治疗血液透析患者动静脉内瘘栓塞近期再通率及远期临床效果.方法 对15例维持性血液透析腕部桡动脉-头静脉自体动静脉内瘘血栓形成患者,在原吻合口稍上方切开瘘管,选用F4～F5大小恰当的Fogarty导管,在球囊萎瘪的状态下轻柔地插入血管腔,导管穿过血栓后,注入适量肝素盐水使导管球囊膨胀,逐渐拉出导管,利用水囊对栓子的牵拉作用将血栓取出,随访5～48个月.结果 15例患者14例采用Fogarty导管取栓成功,血液透析血流量达200ml/min以上.术后Fogarty球囊导管平均使用(21.5±15.4)个月,最长48个月.结论 Fogarty导管应用于动静脉内瘘血栓形成,近期及远期效果良好,延长了自体动静脉内瘘的使用寿命.

Long-term clinical effects of Fogarty catheter on arteriovenous fistula thrombosis

Objective To observe the long-term clinical effects of Fogarty catheter on arteriovenous fistula thrombosis and reperfusion rate in patients on hemodialysis. Methods The thrombosed vascular access was incised and F4 or F5 Fogarty catheter was inserted. After the Fogarty catheter passed through the thrombus, the heparin saline was infused into the balloon and then the catheter was pulled back. All the patients were followed up for 5-48 months. Results In 14 cases of total 15 patients embolisms were removed successfully and the blood flow during hemodialysis reached more than 200 ml/min. The catheter use time was (21.5±15.4) months in average and the longest use time was 48 months. Conclusions The recent and long-term effects of Fogarty catheter is good for arteriovenous fistula thrombosis, which prolongs the use period of autologous arteriovenous fistula and is worthy to be popularized.