摘要
目的:探讨经肱动脉顺行介入置管溶栓在开通血液透析造瘘管阻塞中的疗效价值。材料和方法:经患侧肱动脉顺行插管,先行导丝、导管松解、碎裂血栓,再行造瘘管置管溶栓,术中团注10万U尿激酶,再以微泵2万U/h维持溶栓,狭窄处行球囊成形术,并分析不同时期血栓介入开通的疗效。结果:23例经介入置管溶栓及球囊成形后22例开通,开通率达95.6%,血栓形成时间<48h者21例,24h内溶通21例(100%),尿激酶用量在(22～70)万U;血栓形成时间>48h者2例,1例部分溶通,以球囊扩张后开通,1例溶栓超过48h后出现肌间血肿,放弃溶栓。结论:经肱动脉介入顺行碎栓、溶栓在维持血透管通畅方面安全、有效、简便而且微创。尤其在血栓形成时间<48h中疗效肯定。
Purpose To investigate the efficacy and outcome of interventional treatment in restoring the function of failed native arteriovenous fistulas （AVFs）via brachial artery in hemodialysis patients. Material and Methods Thrombolysis and mechanical thrombectomy were performed by direct brachial artery,puncture using guidewire and catheter. Bolus of 100 000U Urokinase was injected during operation. 20 000U Urokinase per hour was followed to maintain thrombolysis. Stenosis of fistula was treated by PTA. Curative effect of interventional thrombolysis in different time point was analyzed. Results 22 of 23 cases were restored after thrombosis dissolving treatment. with a successful rate of 95%. The thrombus formation time of 21 cases was within 48 hours,and all cases were restored in 24 hours. 220 000-700 000U Urokinase was infused into the thrombosed fistulae; the thrombus formation time of 2 cases was beyond 48 hours：one case was partly restored,received PTA;the other one gived up because of mid-muscle hemorrhage after 48 hours. Conclusions Interventional thrombolysis via brachial artery proved to be a,simple,safe and effective method in restoring the function of failed native AVFs,especially in the patients with the thrombosis within 48 hours.
出处
《中国医学影像学杂志》
CSCD
北大核心
2011年第2期118-120,共3页
Chinese Journal of Medical Imaging
关键词
动静脉瘘
血栓栓塞
血栓溶解疗法
放射摄影术
介入性
肾透析
arteriovenous fistula
thromboembolism
thrombolytic therapy
radiography
interventional
renal dialysis
