超声引导下经皮球囊扩张对动静脉内瘘狭窄患者血管狭窄程度、最大透析流量和术后舒适度的影响
Effect of Ultrasound-guided Percutaneous Balloon Dilation on the Degree of Vascular Stenosis,Maximum Dialysis Flow and Postoperative Comfort in Patients with Arteriovenous Fistula Stenosis
丁常春1
作者信息
- 1. 239400 安徽 明光,明光市人民医院肾内科血透室
- 折叠
摘要
目的 探究超声引导下经皮球囊扩张对动静脉内瘘狭窄患者血管狭窄程度、最大透析流量和术后舒适度的影响.方法 选取2021 年1 月—2023 年1 月收治的动静脉内瘘狭窄 90 例,根据手术方案的不同分为开放手术组43 例和介入治疗组47 例.开放手术组予外科手术治疗,介入治疗组予超声引导下经皮球囊扩张治疗.比较 2 组术后1、3、6 个月时动静脉内瘘畅通率,术前、术后1 个月时血管狭窄处内径、最大透析流量、内瘘自然流量,术前、术后3d时舒适度,并分析2 组术后6 个月内并发症发生情况.结果 术后 6 个月时,介入治疗组动静脉内瘘畅通率高于开放手术组(P＜0.05).术后1 个月时,2 组血管狭窄处内径较术前增大,最大透析流量、内瘘自然流量均较术前增多,且介入治疗组血管狭窄处内径、最大透析流量、内瘘自然流量均大于或高于开放手术组(P＜0.05).术后3d时,2组舒适状况量表(GCQ)生理、心理精神、社会文化、环境评分均较术前下降,但介入治疗组GCQ生理、心理精神、社会文化、环境评分均高于开放手术组(P＜0.05).2 组术后感染、穿刺部位血肿、出血、皮下气肿发生率比较差异均无统计学意义(P＞0.05).结论 超声引导下经皮球囊扩张更有助于保障动静脉内瘘狭窄患者术后远期畅通率,且可显著改善血管狭窄处内径、最大透析流量、内瘘自然流量,提高术后舒适度,并不会导致术后并发症的增多.
Abstract
Objective To investigate the effects of ultrasound-guided percutaneous balloon dilation on the degree of vascular stenosis,maximum dialysis flow and postoperative comfort in patients with arteriovenous fistula stenosis(AFS).Methods In total,90 patients with AFS admitted from January 2021 to January 2023 were divided into open operation group(n =43)and interventional treatment group(n =47)according to different surgical plans.The open operation group received surgical treatment,and the interventional treatment group received ultrasound-guided percutaneous balloon dilation.The pa-tency rate of arteriovenous fistula at 1,3 and 6 months after surgery,the inner diameter of vascular stenosis at 1 month before surgery and 1 month after surgery,the maximum dialysis flow,the natural flow of internal fistula,and the comfort level before surgery and at 3 days after surgery were compared between the two groups.The incidence of complications within 6 months af-ter surgery were analyzed.Results At 6 months after surgery,the patency rate of arteriovenous fistula in interventional treat-ment group was higher than that in open operation group(P＜0.05).At 1 month after surgery,the inner diameter of vascular stenosis in the two groups increased compared with that before surgery,and the maximum dialysis flow and natural internal fis-tula flow increased compared with that before surgery,and the above indicators in interventional treatment group were greater or higher than those in open surgery group(P＜0.05).At 3 days after surgery,the physiological,psychophysiological,socio-cultural and environmental scores in General Comfort Questionnaire(GCQ)of the two groups were lower than those before sur-gery,but the physiological,psychophysiological,sociocultural and environmental scores in GCQ of the interventional treatment group were higher than those of the open surgery group(P＜0.05).There were no significant differences in the incidence of postoperative infection,puncture site hematoma,hemorrhage and subcutaneous emphysema between the two groups(P＞0.05).Conclusion Ultrasound-guided percutaneous balloon dilation is more helpful to ensure the long-term postoperative patency rate of patients with AFS,and can significantly improve the internal diameter of the vascular stenosis,the maximum dialysis flow,and the natural flow of the internal fistula,improve the postoperative comfort,and will not lead to the increase of postoperative complications.
关键词
肾透析/动静脉内瘘狭窄/超声引导下经皮球囊扩张/内瘘畅通率/透析流量/舒适度/手术后并发症/皮下气肿Key words
Renal dialysis/Arteriovenous fistula stenosis/Ultrasound-guided percutaneous balloon dilation/Internal fistula obstruction rate/Dialysis flow/Comfort level/Postoperative complications/Subcutaneous emphysema引用本文复制引用
出版年
2023
国家科技期刊平台
NSTL
万方数据