[1]朱景航,库 媛,黄学卿,等.经皮腔内血管成形术治疗血液透析动静脉内瘘狭窄效果的影响因素分析[J].介入放射学杂志,2018,27(11):1079-1084.
 ZHU Jinghang,KU Yuan,HUANG Xueqing,et al.Percutaneous transluminal balloon angioplasty for the treatment of native hemodialysis arteriovenous fistula stenoses: analysis of factors affecting postprocedural fistula patency[J].journal interventional radiology,2018,27(11):1079-1084.
点击复制

经皮腔内血管成形术治疗血液透析动静脉内瘘狭窄效果的影响因素分析()

PDF下载中关闭

分享到:

《介入放射学杂志》[ISSN:1008-794X/CN:31-1796/R]

卷:
27
期数:
2018年11期
页码:
1079-1084
栏目:
临床研究
出版日期:
2018-11-25

文章信息/Info

Title:
Percutaneous transluminal balloon angioplasty for the treatment of native hemodialysis arteriovenous fistula stenoses: analysis of factors affecting postprocedural fistula patency
作者:
朱景航 库 媛 黄学卿 王黎洲 蒋天鹏 宋 杰 周 石
Author(s):
ZHU Jinghang KU Yuan HUANG Xueqing WANG Lizhou JIANG Tianpeng SONG Jie ZHOU Shi.
Department of Interventional Radiology, Affiliated Hospital of Guizhou Medical University, Guiyang, Guizhou Province 550004, China
关键词:
【关键词】 经皮腔内血管成形术 血液透析 动静脉内瘘
文献标志码:
A
摘要:
【摘要】 目的 探讨经皮腔内血管成形术(PTA)治疗血液透析患者自体动静脉内瘘(AVF)失功能的技术成功率及术后通畅率相关影响因素。方法 回顾性分析2012年1月至2017年1月采用首次PTA治疗的256例血液透析AVF失功能患者临床资料。其中男147例,女109例,平均年龄(59.3±12.4)岁。评估患者年龄、性别、是否伴有糖尿病、原发疾病、内瘘类型、内瘘位置与狭窄位置、长度、程度等影响因素。结果 256例AVF失功能患者中发现364处狭窄。PTA术技术成功率为96.4%(351/364),临床成功率为97.5%(355/364)。术后早期(6个月内)AVF失功能复发与高龄(P<0.001)、伴有糖尿病(P=0.002)呈正相关。伴有糖尿病(P=0.003)、高龄(P<0.001)与一期通畅率较低显著相关;伴有糖尿病(P=0.021)、高龄(P<0.001)、狭窄段较长(P=0.002)、早期复发(P=0.003)及残余狭窄(P=0.013)与二期通畅率较低显著相关。结论 PTA是一种可替代传统手术治疗AVF失功能的有效方法。术后一期、二期通畅率较低的高龄及伴发糖尿病患者必要时可重复接受PTA术,以保持AVF通畅性。

参考文献/References:

[1] Tordoir J, Canaud B, Haage P. EBPG on vascular access[J].Nephrol Dial Transplant, 2007, 22(Suppl 2): ii88- ii117.
[2] 孙晓磊, 马亚蓉, 何虎强, 等. VascuTrakTM球囊导管在自体动静脉内瘘顽固性狭窄闭塞治疗中的应用[J]. 介入放射学杂志, 2016, 25: 590- 594.
[3] Gh K, Mhs M. Primary patency rate of native AV fistula: long term follow up[J]. Int J Clin Exp Med, 2012, 5: 173- 178.
[4] Schwab SJ, Oliver MJ, Suhocki P, et al. Hemodialysis arteriovenous access: detection of stenosis and response to treatment by vascular access blood flow[J]. Kidney Int, 2001, 59: 358- 362.
[5] Clark TW, Hirsch DA, Jindal KJ, et al. Outcome and prognostic factors of restenosis after percutaneous treatment of native hemodialysis fistulas[J]. J Vasc Interv Radiol, 2002, 13: 51- 59.
[6] 徐元恺, 张文云, 段青青, 等. 吻合口动脉端狭窄致自体动静脉内瘘早期失功的初步研究[J]. 中国血液净化, 2016, 15: 494- 497.
[7] Falk A. Maintenance and salvage of arteriovenous fistulas[J]. J Vasc Interv Radiol, 2006, 17: 807- 813.
[8] Rajan DK, Bunston S, Misra S, et al. Dysfunctional autogenous hemodialysis fistulas: outcomes after angioplasty: are there clinical predictors of patency?[J]. Radiology, 2004, 232: 508- 515.
[9] Aktas A, Bozkurt A, Aktas B, et al. Percutaneous transluminal balloon angioplasty in stenosis of native hemodialysis arteriovenous fistulas: technical success and analysis of factors affecting postprocedural fistula patency[J]. Diagn Interv Radiol, 2015, 21: 160- 166.
[10] Kwon H, Choi JY, Ko HK, et al. Comparison of surgical and endovascular salvage procedures for juxta- anastomotic stenosis in autogenous wrist radiocephalic arteriovenous fistula[J]. Ann Vasc Surg, 2014, 28: 1840- 1846.
[11] Feehally J, Floege J, Johnson RJ. Comprehensive clinical nephrology[M]. 3rd ed, Philadelphia: Mosby, 2007: 123- 140.
[12] Roy- Chaudhury P, Kelly BS, Miller MA, et al. Venous neointimal hyperplasia in polytetrafluoroethylene dialysis grafts[J]. Kidney Int, 2001, 59: 2325- 2334.
[13] Heye S, Maleux G, Vaninbroukx J, et al. Factors influencing technical success and outcome of percutaneous balloon angioplasty in de novo native hemodialysis arteriovenous fistulas[J]. Eur J Radiol, 2012, 81: 2298- 2303.
[14] Turmel- Rodrigues L, Boutin JM, Camiade C, et al. Percutaneous dilation of the radial artery in nonmaturing autogenous radial- cephalic fistulas for haemodialysis[J]. Nephrol Dial Transplant, 2009, 24: 3782- 3788.
[15] Manninen HI, Kaukanen ET, Ikaheimo R, et al. Brachial arterial access: endovascular treatment of failing brescia- cimino hemodialysis fistulas: initial success and long- term results[J]. Radiology, 2001, 218: 711- 718.
[16] Kim WS, Pyun WB, Kang BC. The primary patency of percutaneous transluminal angioplasty in hemodialysis patients with vascular access failure[J]. Korean Circ J, 2011, 41: 512- 517.
[17] Mantha M, Killen JP, Baer R, et al. Percutaneous maintenance and salvage of dysfunctional arteriovenous fistulae and grafts by nephrologists in Australia[J]. Nephrology (Carlton), 2011, 16: 46- 52.
[18] Tessitore N, Mansueto G, Bedogna V, et al. A prospective controlled trial on effect of percutaneous transluminal angioplasty on functioning arteriovenous fistulae survival[J]. J Am Soc Nephrol, 2003, 14: 1623- 1627.
[19] Parreira L, Matias P, Amaral T, et al. Endovascular treatment of dysfunctional arteriovenous fistulas and grafts: results from a single centre[J]. J Nephrol Hypert, 2009, 23: 245- 247.
[20] Portugaller RH, Kalmar PI, Deutschmann H. The eternal tale of dialysis access vessels and restenosis: are drug- eluting balloons the solution?[J]. J Vasc Access, 2014, 15: 439- 447.
[21] Aftab SA, Tay KH, Irani FG, et al. Randomized clinical trial of cutting balloon angioplasty ersus high- pressure balloon angioplasty in hemodialysis arteriovenous fistula stenoses resistant to conventional balloon angioplasty[J]. J Vasc Interv Radiol, 2014, 25: 190- 198.
[22] Bountouris I, Kristmundsson T, Dias N, et al. Is repeat PTA of a failing hemodialysis fistula durable?[J]. Int J Vasc Med, 2014, 2014: 369687.

相似文献/References:

[1]何永刚,张军力,詹迎江,等.大剂量动脉灌注化疗联合血液透析治疗晚期肝脏癌肿[J].介入放射学杂志,1998,(04):214.
[2]孟小茜,董伟华,叶朝阳,等. CT静脉造影在血透患者中心静脉狭窄或闭塞介入治疗中的价值[J].介入放射学杂志,2012,(06):465.
 MENG Xiao- xi,DONG Wei- hua,YE Zhao- yang,et al. The application of CT venography in interventional treatment of central vein stenosis or occlusion in hemodialysis patients[J].journal interventional radiology,2012,(11):465.
[3]高 堃,王剑锋,李 惠,等. 血液透析患者中心静脉狭窄的介入治疗[J].介入放射学杂志,2012,(07):582.
 GAO Kun,WANG Jian- feng,LI Hui,et al. Interventional treatment of central vein stenosis in hemodialysis patients[J].journal interventional radiology,2012,(11):582.
[4]黄学卿,王黎洲,周 石,等.血管重建治疗血液透析并发下肢动脉硬化闭塞症患者预后分析[J].介入放射学杂志,2017,(01):118.
 HUANG Xueqing,WANG Lizhou,ZHOU Shi,et al.Vascular remodeling for the treatment of hemodialysis patients complicated with arteriosclerosis obliterans of lower extremity: analysis of prognosis[J].journal interventional radiology,2017,(11):118.
[5]刘幼方,黄天雯,黄勇慧,等.中心静脉闭塞综合征血管腔内治疗的围手术期护理[J].介入放射学杂志,2016,(10):922.
 LIU You- fang,HUANG Tian- wen,HUANG Yong- hui,et al.Perioperative nursing for patients with central venous occlusion disease receiving endovascular treatment[J].journal interventional radiology,2016,(11):922.
[6]姜 燕,司马重阳,苏朝江,等.C形臂CT成像在血液透析患者上腔静脉导管留置治疗中的应用[J].介入放射学杂志,2019,28(04):386.
 JIANG Yan,SIMA Chongyang,SU Chaojiang,et al.Clinical application of C- arm cone beam CT imaging in performing superior vena cava catheter indwelling in hemodialysis patients[J].journal interventional radiology,2019,28(11):386.
[7]赵秋艳,李香茶,张雪梅,等.老年尿毒症患者上腔静脉综合征介入治疗[J].介入放射学杂志,2020,29(05):498.
 ZHAO Qiuyan,LI Xiangcha,ZHANG Xuemei,et al.Interventional treatment of superior vena cava syndrome in elderly patients with uremia[J].journal interventional radiology,2020,29(11):498.
[8]魏花萍,陈 洁.介入治疗血液透析患者人造血管内瘘失功能3次1例[J].介入放射学杂志,2019,28(12):1222.
 WEI Huaping,CHEN Jie..Successful interventional treatment of artificial vascular fistula with three times of dysfunction in a hemodialysis patient: report of one case[J].journal interventional radiology,2019,28(11):1222.
[9]张佳佳,张 蕾,毛莉娟,等.1例经皮肝静脉希氏束起搏器植入患者的护理[J].介入放射学杂志,2021,30(06):541.
 ZHANG Jiajia,ZHANG Lei,MAO Lijuan,et al.Nursing care for a patient receiving His bundle pacemaker implantation via percutaneous hepatic veinous access: preliminary experience[J].journal interventional radiology,2021,30(11):541.
[10]曹莉明,张勇学,何景良,等.DSA导引超滑加硬导丝更换失功能颈内静脉隧道式Cuff透析导管临床应用[J].介入放射学杂志,2023,32(04):362.
 CAO Liming,ZHANG Yongxue,HE Jingliang,et al.Clinical application of super-slippery and hard guide wire in DSA-guided replacement of disfunctional internal jugular vein tunnel-type Cuff dialysis catheter[J].journal interventional radiology,2023,32(11):362.

备注/Memo

备注/Memo:
(收稿日期:2017-12-06)
(本文编辑:边 佶)
更新日期/Last Update: 2018-11-17