摘要
目的:探讨腔内介入技术对透析患者血管通路问题的临床应用效果。方法:选择2020年10月—2022年1月新余市人民医院收治的60例由于血管通路问题无法顺利进行透析治疗的终末期肾脏病(ESRD)患者作为研究对象,60例透析的ESRD患者均行腔内介入技术治疗,包括超声引导下动静脉内瘘球囊扩张术或减影血管造影(DSA)下中心静脉球囊扩张术+支架植入术。统计入选的ESRD患者腔内介入技术治疗后通路开通率,比较其术前、术后肱动脉血流量、血管阻力指数(RI),统计其术后KT/V值(在一定透析时间内透析器对尿素的清除量与体积的比值),统计其术后随访3个月腔内介入技术治疗后远期开放率。结果:60例患者中,采用腔内介入技术治疗后57例患者恢复正常透析,保留血管通路,血管通路开通率为95.00%(57/60)。患者术后的肱动脉血流量高于术前,RI低于术前,差异有统计学意义(t=26.886、15.908,P<0.05)。患者术后的KT/V值为(1.33±0.40),透析充分。术后随访3个月,患者腔内介入技术治疗远期开放率为91.66%(55/60)。结论:腔内介入技术能够解决透析患者的血管通路问题,保证血管通路通畅,提高肱动脉流量,保证透析充分性。
Objective:To investigate the clinical application effect of endovascular interventional technique on vascular access problems in dialysis patients.Methods:60 patients with end-stage renal disease(ESRD)who were unable to undergo dialysis treatment due to vascular access problems in Xinyu People’s Hospital from October 2020 to January 2022 were selected.All 60 ESRD patients on dialysis were treated with endoluminal interventional techniques,including ultrasound-guided arteriovenous fistula balloon dilatation and central venous balloon dilation under DSA+stent implantation.The access opening rate after endovascular interventional technology was calculated,and the brachial artery flow,RI,and dialysis adequacy KT/V values were compared before and after surgery.The patients were followed up for 3 months after surgery.Results:Among 60 patients,57 patients returned to normal dialysis after endovascular interventional treatment,the vascular access was preserved,and the vascular access rate was 95.00%(57/60).Before operation,the difference was statistically significant(t=26.886,15.908;P<0.05).Postoperative KT/V value of patients was(1.33±0.40),and dialysis was sufficient.After 3 months of follow-up,the long-term open rate of endovascular interventional treatment was 91.67%(55/60).Conclusion:Endovascular intervention technology is beneficial to solving the problem of vascular access in dialysis patients,ensuring smooth vascular access,improving brachial artery flow,and ensuring the adequacy of dialysis.
作者
龚丽佳
郑承烈
周群
Gong Lijia;Zheng Chenglie;Zhou Qun(Nephrology Department,Xinyu People’s Hospital,Xinyu,Jiangxi,338000,China)
出处
《黑龙江医学》
2024年第11期1314-1316,共3页
Heilongjiang Medical Journal
基金
新余市科技计划项目(20213090805)。
关键词
透析
腔内介入技术
血管通路问题
通路开通率
肱动脉流量
Dialysis
Endovascular interventional techniques
Vascular access problems
Access patency rate
Brachial artery flow
