Color Doppler ultrasound guided balloon dilation for arteriovenous fistula stenosis of patients with uremia taking maintenance hemodialysis
Objective To explore the application value of color Doppler ultrasound(CDFI)guided balloon dilation of arteriovenous fistula(AVF)in the treatment of patients with uremia taking maintenance hemodialysis(MHD).Methods Five hundred patients with uremia undergoing MHD AVF stenosis at Nanyang First People's Hospital from February 2020 to February 2023 were selected as the study objects,and were divided into an observation group(243 cases)and a control group(257 cases)according the surgical methods.There were 130 males and 113 females in the observation group;they were(49.53±6.23)years old.There were 122 males and 135 females in the control group;they were(50.11±6.98)years old.The observation group underwent CDFI guided AVF balloon dilation,while the control group internal fistula resection and repair.The surgical conditions,internal fistula repair status,oxidative stress indicators[superoxide dismutase(SOD),malondialdehyde(MDA),and myeloperoxidase(MPO)]before and after the dialysis,blood circulation indicators(peak flow rate,internal fistula blood flow volume,and vascular diameter),complications,and internal fistula restenosis 6 months after the dialysis were compared between the two groups.t and x2 tests were applied.Results The surgery success rate and the patency rate of internal fistula in the observation group were higher than those in the control group[97.94％(238/243)vs.82.88％(213/257)and 100.00％(243/243)vs.80.54％(207/257)],with statistical differences(x2=32.060 and 52.529;both P＜0.05).Before the dialysis,there were no statistical differences in the oxidative stress indicators and blood circulation indicators between the two groups(all P＞0.05).Three months after the dialysis,the SOD level,internal fistula blood flow volume,and vascular diameter in the observation group were higher than those in the control group[(89.43±9.76)IU/ml vs.(84.53±9.14)IU/ml,(447.54±27.28)ml/min vs.(383.69±25.39)ml/min,and(3.27±0.42)mm vs.(2.48±0.39)mm];the levels of MDA and MPO and peak flow rate in the observation group were lower than those in the control group[(6.19±0.49)nmol/ml vs.(6.47±0.56)nmol/ml,(39.87±4.92)IU/L vs.(42.18±5.17)IU/L,and(241.64±19.87)cm/s vs.(267.52±20.13)cm/s];there were statistical differences between the two groups(t=5.797,27.106,21.808,5.936,5.112,and 14.459;all P＜0.05).The incidence of complications and the restenosis rate of internal fistula within 6 months after the dialysis in the observation group were lower than those in the control group[10.29％(25/243)vs.16.34％(42/257)and 2.88％(7/243)vs.7.78％(20/257)],with statistical differences(x2=3.945 and 5.874;both P＜0.05).Conclusion CDFI guided AVF balloon dilation for uremic patients taking MHD can increase the patency rate of internal fistula and surgery success rate,improve their blood circulation,and reduce their oxidative stress response and the risk of postoperative internal fistula restenosis,and is safe.
万方数据
维普
