【摘要】目的评估经皮腔内血管成形术(percutaneous transluminal angioplasty，PTA)治疗未成熟的动静脉内瘘(arteriovenous fistula，AVF)的疗效及安全性。方法选取2017 年1 月～2018 年5月在武汉市中心医院肾内科初次行前臂AVF 手术的患者，术后6 周体检及彩超评估AVF 成熟情况，未达到AVF 临床成熟标准的23 例患者行PTA 促成熟。术后24h 再次彩超评估血管，并观察AVF 初级通畅时间。结果23 例患者中，19 例(82.60%)为I 型狭窄，临床及技术成功率均为100%，PTA 术后24h 与术前相比，狭窄处血管内径,、血流量增加明显，差异具有统计学意义(t 值分别为- 31.630，- 27.557；P 值分别为＜0.001，＜0.001)；PTA 术后3 月、6 月、12 月的初级通畅率分别为94.4%、87.2%、78.5%；无严重不良并发症出现。结论PTA 促成熟是治疗未成熟AVF 的有效方法，能获得较好的初级通畅率，其技术安全。
【Abstract】Objective To evaluate the efficacy and safety of percutaneous transluminal angioplasty (PTA) to promote arteriovenous fistula (AVF) maturation. Methods A total of 23 patients with immature AVF in the period from Jan 2017 to May 2018 underwent PTA to promote AVF maturation at the 6th week after AVF surgery. The changes of hemodynamics in AVF after PTA for 24h were measured by Doppler ultrasonography, and the primary patency rate was observed. Results Of the 23 patients with immature AVF, 19 (82.60%) patients had type I AVF stenosis. Clinical and anatomic success of PTA were 100%. The inner diameter and blood flow at the stenosis increased significantly after PTA for 24 hours as compared with those before PTA (t= -31.630 and -27.557 respectively; P< 0.001 and < 0.001 respectively). The primary patency rates were 94.4%, 87.2% and 78.5% after PTA for 3 months, 6 months and 12 months respectively. No serious adverse complications occurred. Conclusion PTA was safe and effective to promote AVF maturation with a higher primary patency rate.
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