DSA和彩超引导下的经皮血管成形术治疗血液透析患者动静脉内瘘狭窄的疗效

目的 比较数字减影血管造影（DSA）和彩超引导下的经皮血管成形术（PTA）治疗血液透析患者动静脉内瘘狭窄的疗效。方法 回顾性分析2017年1月至2019年9月蚌埠医学院第三附属医院肾内科收治的动静脉内瘘狭窄的血液透析患者共78例，根据手术方式不同分为DSA组43例，彩超组35例。比较两组术后并发症发生率及术前、术后1天狭窄处内径、血液透析血流量、肱动脉血流量的变化，观察术后1、3、6、9个月时患者内瘘初级通畅率。结果 两组患者术后并发症发生率差异无统计学意义（P>0.05）。两组患者术前狭窄处内径、血液透析血流量、肱动脉血流量比较，差异均无统计学意义（P>0.05）。两组患者术后1天与术前狭窄处内径、血液透析血流量及肱动脉血流量差值比较，差异均无统计学意义（t=-1.226、1.594、0.527，P>0.05）。两组术后第1、3、6、9个月的初级通畅率比较，差异无统计学意义（P>0.05）。结论 DSA和彩超引导下的PTA对动静脉内瘘狭窄的治疗效果相当。

Efficacy of DSA guided percutaneous angioplasty and color ultrasound-guided percutaneous angioplasty in treatment of arteriovenous fistula stenosis in dialysis patients

Objective To observe and compare the therapeutic effect of PTA guided by DSA and color ultrasound in the treatment of arteriovenous fistula stenosis in dialysis patients.Methods A retrospective analysis was performed on the clinical data of 78 cases of dialysis patient sadmitted to the Third Affiliated Hospital of Bengbu Medical College from January 2017 to September 2019 in the treatment of arteriovenous fistula stenosis.There were 43 cases in DSA group and 35 cases in color Doppler ultrasound group. The incidence of postoperative complications was compared between the two groups.The changes in the internal diameter, dialysis blood flow, and brachial artery blood flow of the two groups before and after surgery were compared. The incidence of fistula restenosis and primary patency within 1, 3, 6, and 9 months after operation were observed.Results There was no significant difference in the incidence of postoperative complications between the two groups (P>0.05). There was no statistically significant difference between the two groups in preoperative stenosis diameter, hemodialysis blood flow and brachial artery blood flow (P>0.05).There was no statistically significant difference in the difference values of internal diameter at the stenosis, hemodialysis blood flow and brachial artery blood flow between the two groups on day 1 after surgery (t=-1.226, 1.594, 0.527, P>0.05).There was no significant difference in patency rate 1,3,6 and 9 months after operation between the two groups (P>0.05).Conclusion Both DSA and PTA guided by color Doppler ultrasound are effective, which have similar effect in the treatment of arteriovenous fistula stenosis.