应用腔内血管成形术更换血液透析长期导管

doi:10.3969/j.issn.1006-298X.2020.02.006

肾脏病与透析肾移植杂志

应用腔内血管成形术更换血液透析长期导管

出版日期:2020-04-28 发布日期:2020-05-08

Application of percutaneous transluminal angioplasty to replace tunnelcuffed catheter in maintenance hemodialysis patients

Online:2020-04-28 Published:2020-05-08

摘要/Abstract

摘要： 目的：探讨应用腔内血管成形术（PTA）更换维持性血液透析(MHD)患者带隧道和涤纶套透析导管（TCC）的疗效及安全性。
方法：回顾性分析蚌埠医学院第一附属医院2017年10月至2019年10月收治的12例MHD合并TCC并发症患者的临床资料，行数字显影血管造影技术（DSA）下原导管腔内和(或)狭窄段血管球囊扩张术并行新导管更换术。观察术后即时和6个月内导管功能情况。
结果：12例患者在行导管更换时发现6例导管嵌顿，经PTA治疗后顺利拔管；全部患者PTA后均成功行再置管术，术后导管即时透析血流量>250 ml/min，术后随访3个月时初级通畅率为100%，6个月初级通畅率为75%。
结论：腔内治疗TCC并发症患者行拔管和再置管手术创伤小，成功率高，患者耐受性较好，能很好解决MHD患者通路不足问题。

关键词: 腔内血管成形术, 更换导管, 长期导管功能不良, 维持性血液透析

Abstract: Ｏｂｊｅｃｔｉｖｅ：To investigate outcome and security of percutaneous transluminal angioplasty (PTA) in tunnelcuffed catheter(TCC) replacement maintenance hemodialysis (MHD) patients with catheter dysfunction.
Ｍｅｔｈｏｄｏｌｏｇｙ：12 cases of catheter dysfunction MHD patients from Oct 2017 to Oct 2019 admitted into the First Affiliated Hospital of Bengbu medical college were retrospectively analyzed.All of them underwent digital subtraction angiography (DSA) to clarify problem origin.Suitable balloons were chosen to dilate the lumen of original catheters or the occlusive veins,and then the original catheters were replaced.PTA was used to help catheter replacement and all patients were followed up for 6 months.
Ｒｅｓｕｌｔｓ：6 of the 12 patients were found stuck when replacing catheters.All of them had catheters removed successfully with PTA.All patients had catheter replacement successfully and dialyzed with blood flow volume>250 ml/min,and the primary catheter site patency rates of 12 patients with PTA at 3 and 6 months after surgery were 100%,75%.
Ｃｏｎｃｌｕｓｉｏｎ：PTA shows advantages of lesser trauma,better tolerance and higher success rate in patients with TCC dysfunction.It is an effective treatment for the vascular access depletion in MHD patients.

Key words: percutaneous transluminal angioplasty, catheter replacement, tunnel-cuffed catheter dysfunction, maintenance hemodialysis

张继强，陈峥，常保超，等. 应用腔内血管成形术更换血液透析长期导管[J]. 肾脏病与透析肾移植杂志, DOI: 10.3969/j.issn.1006-298X.2020.02.006.

ZHANG Jiqiang,CHEN Zheng,CHANG Baochao, et al. Application of percutaneous transluminal angioplasty to replace tunnelcuffed catheter in maintenance hemodialysis patients[J]. Chinese Journal of Nephrology, Dialysis & Transplantation, DOI: 10.3969/j.issn.1006-298X.2020.02.006.

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ISSN 1006-298X CN 32-1425/R

应用腔内血管成形术更换血液透析长期导管

Application of percutaneous transluminal angioplasty to replace tunnelcuffed catheter in maintenance hemodialysis patients

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