Effect of Ultrasound-Guided Percutaneous Balloon Dilation in the Treatment of Type Ⅰ and Type Ⅱ Stenosis of Autologous Arteriovenous Fistula
Objective To observe the clinical efficacy of ultrasound-guided percutaneousballoon dilation in the treatment of type Ⅰ and type Ⅱ stenosis of autologous arteriovenous fistula(AVF).Methods A retrospective analysis was conducted on 156 patients with AVF stenosis ad-mitted to the Department of Nephrology at the First Affiliated Hospital of Nanchang University from January 2020 to May 2022.Among them,76 patients underwent traditional surgery as the control group,and 80 patients underwent ultrasound-guided percutaneous balloon dilation as the observation group.The surgical success rate and temporary deep vein catheterization rate were re-corded;primary fistula patency rate at 3,6 and 12 months after surgery,surgical complications,therapeutic effect and follow-ups were observed and compared between the two groups.Results In the observation group,77 cases(96.3％)were successfully treated,and 2 of the remaining 3 ca-ses were converted to open surgery for ipsilateral internal fistula,and 1 case was converted to re-construction of endocardial fistula of the contralateral upper limb;in the control group,74 cases(97.4％)were successfully treated,and the remaining 2 cases were converted to tunnel-cuffed catheter(TCC)for postoperative endocardial fistula occlusion;there was no statistically signifi-cant difference in the success rate between the two groups of techniques(P＞0.05).The dialysis blood flow of patients undergoing hemodialysis for the first time after successful surgery could meet the demand for hemodialysis,and there were no perioperative deaths.The rate of temporary deep vein catheteri zation caused by surgery was lower in the observation group than that in the control group(P＜0.05).At 6 and 12 months after surgery,the primary patency rate of internal fistula were lower in the observation group than those in the control group(P＜0.05).The inter-nal diameter of AVF stenosis,the passing blood flow through the brachial artery,and the dialysis blood flow of the first hemodialysis in the 2 groups were higher than those before surgery in the immediate postoperative period,and they were higher in the observation group than those in the control group(P＜0.05).The incidence of restenosis or thrombosis was 38.8％in the observation group,which was higher than that of 18.4％in the control group(x2=7.847,P＜0.05).Conclusion Ultrasound-guided balloon dilation for type Ⅰ and Ⅱ stenosis of AVF can reduce patients'vascular damage,protect vascular resources,expand the inner diameter of the stenosis site,and increase the natural blood flow of the fistula.This surgical method might have a higher rate of restenosis and a lower rate of long-term patency compared with the traditional surgery,but it could be less inva-sive with minimal trauma and could be immediately used for hemodialysis after surgery,with a high success rate,fewer complications,and a low rate of temporary deep vein catheterization.
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万方数据
维普
