实用医院临床杂志
實用醫院臨床雜誌
실용의원림상잡지
PRACTICAL JOURNAL OF CLINICAL MEDICINE
2015年
4期
49-51,52
,共4页
解德琼%朱军%唐前容%朱磊%李程%赵平
解德瓊%硃軍%唐前容%硃磊%李程%趙平
해덕경%주군%당전용%주뢰%리정%조평
血液透析%动静脉内瘘%经皮血管成形术
血液透析%動靜脈內瘺%經皮血管成形術
혈액투석%동정맥내루%경피혈관성형술
Hemodialysis%Arteriovenous fistula%Percutaneous transluminal angioplasty
目的：观察经皮腔内血管成形术（percutaneous transluminal angioplasty ，PTA）在糖尿病肾病血液透析患者动静脉内瘘狭窄中的应用效果。方法选择20例基础疾病为糖尿病肾病的血液透析动静脉内瘘狭窄患者进行 PTA 治疗，比较 PTA治疗前后的血管造影表现、透析血流量及静脉压变化。结果19例患者经球囊扩张后，狭窄段明显扩张，触诊感血管震颤增强，经造影证实狭窄小于30％。术后首次血液透析血流量由扩张前（124．32±18．43）ml／min 增至（242．12±16．35）ml／min；在血流量为250 ml／min 时，静脉压由扩张前的（178．46±13．4）mmHg 降至（98．62±14．36）mmHg；kt／V 较前明显提高，差异有统计学意义（P ＜0．05）。术中未出现血管破裂、出血及血栓形成等并发症。结论 PTA 是治疗糖尿病肾病血液透析患者动静脉内瘘狭窄的有效方法，其操作简便、创伤小、近期效果明显，对血液透析动静脉内瘘的维护有重要价值．
目的：觀察經皮腔內血管成形術（percutaneous transluminal angioplasty ，PTA）在糖尿病腎病血液透析患者動靜脈內瘺狹窄中的應用效果。方法選擇20例基礎疾病為糖尿病腎病的血液透析動靜脈內瘺狹窄患者進行 PTA 治療，比較 PTA治療前後的血管造影錶現、透析血流量及靜脈壓變化。結果19例患者經毬囊擴張後，狹窄段明顯擴張，觸診感血管震顫增彊，經造影證實狹窄小于30％。術後首次血液透析血流量由擴張前（124．32±18．43）ml／min 增至（242．12±16．35）ml／min；在血流量為250 ml／min 時，靜脈壓由擴張前的（178．46±13．4）mmHg 降至（98．62±14．36）mmHg；kt／V 較前明顯提高，差異有統計學意義（P ＜0．05）。術中未齣現血管破裂、齣血及血栓形成等併髮癥。結論 PTA 是治療糖尿病腎病血液透析患者動靜脈內瘺狹窄的有效方法，其操作簡便、創傷小、近期效果明顯，對血液透析動靜脈內瘺的維護有重要價值．
목적：관찰경피강내혈관성형술（percutaneous transluminal angioplasty ，PTA）재당뇨병신병혈액투석환자동정맥내루협착중적응용효과。방법선택20례기출질병위당뇨병신병적혈액투석동정맥내루협착환자진행 PTA 치료，비교 PTA치료전후적혈관조영표현、투석혈류량급정맥압변화。결과19례환자경구낭확장후，협착단명현확장，촉진감혈관진전증강，경조영증실협착소우30％。술후수차혈액투석혈류량유확장전（124．32±18．43）ml／min 증지（242．12±16．35）ml／min；재혈류량위250 ml／min 시，정맥압유확장전적（178．46±13．4）mmHg 강지（98．62±14．36）mmHg；kt／V 교전명현제고，차이유통계학의의（P ＜0．05）。술중미출현혈관파렬、출혈급혈전형성등병발증。결론 PTA 시치료당뇨병신병혈액투석환자동정맥내루협착적유효방법，기조작간편、창상소、근기효과명현，대혈액투석동정맥내루적유호유중요개치．
Objective To observe the clinical effect of percutaneous transluminal angioplasty (PTA) in the treatment of arte-riovenous fistula stenosis in diabetic nephropathy (DN) patients with hemodialysis.Methods Twenty hemodialytic DN patients with arteriovenous fistula stenosis were selected to have PTA .The angiographic findings,changes in blood flow volume and venous pressure level during hemodialysis between pre -and post-operation were compared.Results In 19 patients,the stenotic segment was dilated,the occluded site was re-canalized and the palpation feeling of thrill became stronger immediately after PTA .The stenosis was less than 30% confirmed by angiography.The hemodialysis blood flow was increased from (124.32 ±18.43)ml/min of pre-operation to(242.12 ±16.35)ml/min of post-operation.The venous pressure was decreased from (178.46 ±13.4 ) mmHg of pre-operation to (98.62 ± 14.36)mmHg of post-operation when blood flow volume was 250 ml/min.No complications such as vascular perforation ,hemorrhage and thrombosis were observed during the operation .Conclusion PTA is an effective,safe and micro-invasive treatment for arteriove-nous fistula stenosis or occlusion .It could be chosen as the treatment for certain patients with indications .
