裸支架与单纯球囊扩张治疗血透通路中心静脉狭窄的疗效对比
Comparison of bare metal stent and balloon dilatation in the treatment of central venous stenosis in hemodialysis patients
目的 探讨并比较裸支架植入和单纯球囊扩张(PTA)治疗血液透析患者中心静脉狭窄(CVS)的疗效.方法 回顾性分析上海交通大学医学院附属仁济医院血管外科自2015年1月至2018年12月收治的40例CVS的血液透析患者临床资料,分析患者的基础信息、病变部位、穿刺入路、治疗方式和技术成功率,根据治疗方式分为PTA组和支架组,并比较两组术后6、12个月的一期、二期通畅率.结果 40例患者中,38例治疗成功,技术成功率为95.0%(38/40),17例行单纯PTA(PTA组),21例行PTA联合裸支架植入(支架组).35例患者获得随访,随访率为92.1%(35/38),随访时间为(22.5±12.8)个月.支架组术后6、12个月的一期通畅率分别为89.5%和57.9%,PTA组术后6、12个月的一期通畅率为56.3%、31.3%,支架组的一期通畅率高于PTA组(P=0.045).支架组和PTA组术后12个月的二期通畅率分别为87.5%和94.7%,两者差异无统计学意义.结论 腔内介入是治疗血透患者CVS安全有效的方法,支架组的一期通畅率优于单纯PTA组.
更多Objective To compare the clinical efficacy between bare-metal stent and percutaneous transluminal angioplasty (PTA) in patients with central venous stenosis (CVS). Methods From Jan. 2015 to Dec. 2018, 40 patients with CVS were included in this study. Basic information, lesion location, puncture approach , treatment method and technical success rate were analyzed . The 6-month and 12-month primary patency rate and secondary patency rate were compared between patients treated by bare-metal stent (stent group) and PTA (PTA group). Results Thirty-eight cases were treated successfully in all 40 patients. The technical success rate was 95.0%. Seventeen cases underwent PTA and 21 cases underwent stent implantation. Follow-up was conducted in 35 patients. The follow-up rate was 92.1%, and the follow-up time was (22.5±12.8) months. The 6-month, 12-month primary patency rate were 89.5%, 57.9% of stent group, and 56.3%, 31.3% of PTA group, respectively. The primary patency rate of stent group was significantly higher than that of PTA group ( P=0 . 045 ) . The secondary patency rate of stent group and PTA group were 87 . 5% and 94 . 7%, respectively. And there was no statistical difference observed between two groups. Conclusion Endovascular intervention is a safe and effective treatment for CVS, the primary patency rate of stent group is higher than that of PTA group.
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