| 姜燕,熊智倩,刘俪婷,苏朝江,陈彦,张帅,刘宗旸.比较直接或于超声引导下经皮腔内血管成形扩张桡动脉后及反“J”型移植物建立动静脉瘘用于接受血液透析而相应血管细小患者[J].中国介入影像与治疗学,2025,22(3):159-163 |
| 比较直接或于超声引导下经皮腔内血管成形扩张桡动脉后及反“J”型移植物建立动静脉瘘用于接受血液透析而相应血管细小患者 |
| Comparison on direct and after ultrasound-guided percutaneous transluminal angioplasty of radial artery arteriovenous fistula formation and reverse “J” arteriovenous graft formation in hemodialysis patients with relative small diameter vessels |
| 投稿时间：2024-10-15 修订日期：2024-12-23 |
| DOI：10.13929/j.issn.1672-8475.2025.03.002 |
| 中文关键词: 肾透析 动静脉瘘 血管成形术 超声检查，介入性 |
| 英文关键词:renal dialysis arteriovenous fistula angioplasty ultrasonography,interventional |
| 基金项目:北京健康促进会中国血液透析血管通路青年医师研究项目（MSXM002）。 |
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| 中文摘要: |
| 目的 比较直接或于超声引导下以经皮腔内血管成形（PTA）扩张桡动脉后建立动静脉瘘（AVF），以及利用反“J”型移植物建立移植物动静脉瘘（AVG）用于需要接受血液透析而相应血管细小患者的价值。方法 回顾性纳入96例计划接受血液透析治疗而桡动脉远端直径＜1.5 mm、头静脉直径≥2.0 mm的终末期肾病患者，根据造瘘方案将其分为AVF组（n=30）、PTA+AVF组（n=34）及AVG组（n=32）；比较3组技术成功率、临床成功率、初级通畅率及次级通畅率。结果AVF组、PTA+AVF组及AVG组技术成功率分别为80.00%、94.12%及100%，临床成功率分别为30.00%、82.35%及93.75%；3组间差异均有统计学意义（P均＜0.05）。AVF组1、3、6、9及12个月初级通畅率分别为80.00%、30.00%、27.59%、27.59%及24.14%，PTA+AVF组分别为94.12%、82.35%、78.79%、68.75%及62.50%，AVG组分别为100%、93.33%、83.33%、76.67%及66.67%；3组间差异均有统计学意义（P均＜0.05）。AVF组1、3、6、9及12个月次级通畅率分别为83.33%、75.00%、75.00%、70.83%及58.33%，PTA+AVF组分别为93.33%、93.33%、83.33%、83.33%及80.00%，AVG组分别为100%、100%、93.33%、90.00%及80.00%；3组间差异亦均有统计学意义（P均＜0.05）。结论 相比直接及经超声引导下以PTA扩张桡动脉后建立AVF，AVG用于需要接受血液透析而相应血管细小患者效果更佳。 |
| 英文摘要: |
| Objective To compare the application value of direct arteriovenous fistula （AVF）， after ultrasound-guided percutaneous transluminal angioplasty （PTA） dilation of radial artery AVF formation and reverse “J” arteriovenous graft （AVG） in hemodialysis patients with small diameter vessels. Methods Totally 96 end-stage renal disease patients with distal radial artery＜1.5 mm and cephalic vein≥2.0 mm who planning to receive hemodialysis were retrospectively enrolled. The patients were divided into AVF group （n=30）， PTA+AVF group （n=34） and AVG group （n=32） according to fistulization methods. The technical success rate， clinical success rate， primary patency rate and secondary patency rate were compared among groups. Results The technical success rate of AVF group， PTA+AVF group and AVG group was 80.00%， 94.12% and 100%， respectively， and the clinical success rate was 30.00%， 82.35% and 93.75%， respectively， with significant differences among 3 groups （both P＜0.05）. The primary patency rate 1， 3， 6， 9 and 12 months after fistulization in AVF group was 80.00%， 30.00%， 27.59%， 27.59% and 24.14%， respectively， in PTA+AVF group was 94.12%， 82.35%， 78.79%， 68.75% and 62.50%， respectively， while in AVG group was 100%， 93.33%， 83.33%， 76.67% and 66.67%， respectively， all being significant different among 3 groups （all P＜0.05）. The secondary patency rate 1， 3， 6， 9 and 12 months after fistulization in AVF group was 83.33%， 75.00%， 75.00%， 70.83% and 58.33%， respectively， in PTA+AVF group was 93.33%， 93.33%， 83.33%， 83.33% and 80.00%， respectively， while in AVG group was 100%， 100%， 93.33%， 90.00% and 80.00%， respectively， also being significant different among 3 groups （all P＜0.05）. Conclusion Compared with direct and after ultrasound-guided PTA dilation of radial artery AVF formation， AVG formation was more valuable for hemodialysis patients with small diameter vessels. |
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