目的 探究超声引导下经皮球囊扩张术应用于动静脉内瘘狭窄治疗中的效果。 方法 2018年1月—2022年9月湖北省黄冈市浠水县中医院开展动静脉内瘘狭窄手术治疗探究，从收治的此类患者中随机选取病例，共82例，按照选取顺序编号，采用随机分组，设为对照组及试验组，前者开展经皮血栓切除术治疗，后者开展超声引导下经皮球囊扩张术治疗，比较2组内瘘通畅率、再狭窄发生情况、手术后并发症和相关临床指标。 结果 试验组手术后3个月、6个月、12个月内瘘通畅率分别为90.24%、85.36%、80.47%，均高于对照组(χ2=3.998、4.232、4.661，P=0.046、0.040、0.031)；手术后3个月、6个月、12个月内瘘再狭窄率分别为2.44%、7.32%、14.63%，均低于对照组(χ2=3.905、4.479、5.185，P=0.048、0.034、0.023)；试验组并发症发生率为2.44%，低于对照组(χ2=3.905，P=0.048)；试验组手术后狭窄处内径、透析血流量、内瘘自然流量大于对照组(t=12.425、5.391、7.875，均P＜0.001)。 结论 在动静脉内瘘狭窄患者治疗中，超声引导下经皮球囊扩张术应用于血管通路狭窄/闭塞治疗时安全性较高，能够改善再狭窄，利于患者内瘘震颤恢复，值得推广。
Objective To explore the ultrasound guided percutaneous balloon dilatation applied to the treatment of arteriovenous internal fistula (AVF) stenosis for blood access. Methods A total of 82 patients with AVF stenosis treated with surgical intervention in Xishui County Traditional Chinese Medicine Hospital of Huanggang City during January 2018 to September 2022 were enrolled in this study. They were randomly divided into experiment group and control group based on the order of case number. Ultrasound guided percutaneous balloon dilatation was performed in the experiment group, and percutaneous thrombectomy was used for the control group. Patent of the AVF, restenosis of the AVF, complication of the surgical intervention and related clinical indicators were compared between the two groups. Results In the experiment group, patent rates of the AVF were 90.24%, 85.36% and 80.47% after the operation for 3 months, 6 months and 12 months respectively, higher than those in the control group (χ2=3.998, 4.232 and 4.661 respectively; P=0.046, 0.040 and 0.031 respectively); restenosis rates of the AVF were 2.44%, 7.32% and 14.63% after the operation for 3 months, 6 months and 12 months respectively, lower than those in the control group (χ2=3.905, 4.479 and 5.185 respectively; P=0.048, 0.034 and 0.023 respectively); complication rate of the intervention was 2.44%, lower than that in the control group (χ2=3.905, P=0.048); after ultrasound guided percutaneous balloon dilatation intervention, the internal diameter at the previous stenosis site, blood access volume and blood flow were greater than those in the control group (t=12.425, 5.391 and 7.875 respectively; P＜0.001). Conclusion Ultrasound guided percutaneous balloon dilatation for the treatment of AVF stenosis and occlusion has the advantages of higher success and safety rates, real-time to display the patency and multi-angle images, and disappearance of AVF tremor after the intervention. Therefore, this method is worth to be widely used clinically.
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