超声引导PTA在动静脉内瘘狭窄中的应用研究

目的:探究分析超声引导下经皮穿刺腔内血管成型术(PTA)在动静脉内瘘狭窄治疗中的应用效果。方法:选择2017年9月-2019年9月在我院进行超声引导下经皮穿刺腔内血管成型术治疗的78例动静脉内瘘狭窄患者为研究对象,记录技术成功率、临床治疗成功率,并比较治疗前后狭窄处内径、内瘘自然流量以及透析血流量。结果:101例次在超声引导下进行PTA治疗的技术成功率达到97.03%,临床成功率93.07%,且治疗后患者的狭窄处内径、内瘘自然流量以及透析血流量平均值均显著大于术前治疗(P<0.05)。术后有3例局部出现肿胀,经弹力绑带加压包扎后症状消失。结论:超声引导下进行经皮穿刺腔内血管成型术具有操作简单、无辐射、治疗成功率高、并发症少等优点,将其应用于动静脉内瘘狭窄治疗中能够直观观察到动静内瘘血管血流及管腔变化情况,并实时察看导丝、球囊的行进情况,临床应用价值高。

Application of ultrasound-guided PTA in arteriovenous fistula stenosis

Objective To explore and analyze the effect of ultrasound-guided percutaneous transluminal angioplasty(PTA) in the treatment of arteriovenous fistula stenosis.Methods From September 2017 to September 2019,78 patients with arteriovenous fistula stenosis treated by percutaneous transluminal angioplasty under the guidance of ultrasound were selected as the study object.The success rate of technique and clinical treatment were recorded,and the diameter of stenosis,natural flow of internal fistula and dialyzed blood flow were compared before and after treatment.Results The success rate of PTA under ultrasound guidance was 97.03%,and the clinical success rate was 93.07%.After treatment,the mean values of stenosis diameter,internal fistula natural flow and dialysis blood flow in 78 patients were significantly higher than before treatment(P<0.05).There were 3 cases of local swelling after operation,and the symptoms disappeared after compression bandaging with elastic bandage.Conclusion Ultrasound-guided percutaneous transluminal angioplasty has the advantages of simple operation,no radiation,high success rate and few complications.When it is used in the treatment of arteriovenous internal fistula stenosis,the changes of blood flow and lumen of arteriovenous internal fistula can be observed directly,and the progress of guide wire and balloon can be observed in real time,which has high clinical application value.