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目的:探讨动静脉内瘘(AVF)失功后介入手术的治疗方法,评估其治疗效果及应用价值。方法:回顾性分析自2006年4月—2015年1月行介入手术治疗的20例自体AVF失功患者的临床资料。结果:20例患者中,16例经静脉端造影,4例经股动脉-主动脉-腋动脉路径造影;单纯吻合口狭窄4例,行球囊扩张后狭窄明显改善;吻合口狭窄伴血栓形成有5例,切开取栓后再行球囊扩张治疗;静脉端血栓形成3例,切开取栓后返血良好;静脉端狭窄合并血栓形成7例,行切开取栓后再行球囊扩张治疗;头静脉长段闭塞1例,改用人工血管行AVF术。术后全部患者经该血管通路恢复透析治疗,透析时流量均>200 m L/min。共17例患者获得随访,平均随访时间13.2个月,12个月通畅率为47.1%。结论:介入导管技术在治疗AVF失功方面是安全、有效的。
Objective: To investigate the treatment of interventional surgery after arteriovenous fistula (AVF) failure and evaluate its therapeutic effect and application value. Methods: The clinical data of 20 patients with autologous AVF failure treated with interventional surgery from April 2006 to January 2015 were retrospectively analyzed. Results: Of the 20 patients, 16 were diagnosed by venous endoscopy and 4 by femoral artery-aorta-axillary artery imaging. Only 4 cases had simple anastomotic stenosis. The stenosis was significantly improved after balloon dilatation. The anastomotic stricture and thrombosis There were 5 cases who underwent balloon dilatation after thrombectomy. Venous terminal thrombosis was performed in 3 cases. After thrombectomy, blood returned was good. Venous end stenosis was associated with thrombosis in 7 cases. Balloon dilatation treatment; long vein occlusion in 1 case, switch to artificial vascular line AVF. All patients were resumed dialysis after the vascular access, dialysis flow were> 200 m L / min. A total of 17 patients were followed up with an average follow-up time of 13.2 months and a patency rate of 12 months of 47.1%. Conclusion: Interventional catheterization is safe and effective in treating AVF failures.