【摘要】 目的:探讨经皮血管成形术(PTA)治疗血液透析患者动静脉内瘘狭窄和闭塞的临床效果。方法:对16例动静脉内瘘狭窄和闭塞的血液透析患者行PTA治疗,比较PTA治疗前后的血管造影表现、透析时血流量及静脉压的变化情况。结果:术后血管造影显示狭窄和闭塞的血管扩张、再通,触诊感血管震颤增强。术后第2天透析时血流量升高至200ml/min以上,可完成透析,在血流量为250ml/min时静脉压下降为(110.62±15.71)mmHg;其中2例分别在术后3个月和6个月发生再狭窄,再次行PTA后血流量恢复。所有患者均未出现血管破裂、出血、血栓形成等并发症。结论:PTA是治疗动静脉内瘘狭窄和闭塞的有效、安全、微创的方法,可选择适宜的患者采用。更多还原

【Abstract】 Objective:To observe the clinical effect of percutaneous transluminal angioplasty(PTA) for the treatment of arteriovenous fistula stenosis or occlusion in hemodialysis patients.Methods:PTA was performed in 16 hemodialysis patients with arteriovenous fistula stenosis or occlusion.The pre-and post-operative angiographic findings,the volume of blood flow,and the level of venous pressure during hemodialysis were compared.Results:The stenotic segment was dilated,the occluded site was re-canalized and the palpation feeling of thrill became stronger immediately after PTA.During the second day of hemodialysis treatment,as the volume of blood flow increased to more than 200ml/min,the procedure of hemodialysis could be finished.As the volume of blood flow reached 250ml/min,the venous pressure could decrease to 110.62±15.71mmHg.Recurrent stenosis was found in 2 cases at 3 and 6 months after treatment,the volume of blood flow returned to normal after the second PTA was performed.No complications such as vascular perforation,hemorrhage and thrombosis were observed.Conclusions:PTA is an effective,safe and micro-invasive treatment for arteriovenous fistula stenosis or occlusion and could be chosen as the treatment for certain patients with indication.更多还原