医学影像学杂志

目的 探讨超声造影在经皮球囊扩张血管成形术（PTA）治疗自体动静脉内瘘（AVF）狭窄中的应用效果。方法 选取60例AVF狭窄患者，根据治疗方案不同分为观察组31例和对照组29例，观察组采用常规超声检查+超声造影+PTA，对照组采用常规超声检查+PTA。比较手术一次性成功率、AVF狭窄部位血管内径和血流量、肱动脉血流量和肱动脉阻力指数以及术后并发症。结果 观察组手术一次性成功率为96.77%，高于对照组的75.86%，差异有统计学意义（P<0.05）。两组术后AVF狭窄部位血管内径和血流量、肱动脉血流量均大于术前，且观察组大于对照组，差异有统计学意义（P均<0.05）；两组术后肱动脉阻力指数小于术前，且观察组小于对照组，差异有统计学意义（P<0.05）。两组术后并发症总发生率比较差异无统计学意义（P>0.05）。结论 超声造影用于PTA治疗AVF狭窄能够为PTA实施提供详细的影像学信息，从而提升操作准确性，提高手术成功率，减少术后并发症的发生。

Objective To analyze the application effect of contrast-enhanced ultrasound in the treatment of autologous arteriovenous fistula stenosis by percutaneous transluminal angioplasty. Methods Sixty patients with AVF stenosis were selected and divided into an observation group of 31 cases and a control group of 29 cases according to different treatment plans. 31 patients in the observation group were treated with routine ultrasound examination+contrast-enhanced ultrasound+PTA, and 29 patients in the control group were treated with routine ultrasound examination+PTA. The one-time success rate of surgery, diameter and blood flow at the stenosis site of AVF, blood flow and resistance index of brachial artery, and postoperative complications were compared. Results The one-time success rate of surgery in the observation group was 96.77%, which was higher than 75.86% in the control group, and the difference was statistically significant(P<0.05). The diameter and blood flow at the stenosis site of AVF and blood flow of brachial artery in the two groups after operation were higher than those before operation, and those in the observation group were higher than those in the control group, and the differences were statistically significant(all P<0.05); The resistance index of brachial artery of the two groups after operation was lower than that before operation, and that of the observation group was lower than that of the control group, and the differences were statistically significant(all P<0.05). There was no significant difference in the total incidence of postoperative complications between the two groups(P>0.05). Conclusion Contrast-enhanced ultrasound for PTA in the treatment of AVF stenosis can provide detailed imaging information for the implementation of PTA, so as to improve the accuracy of operation, to increase the success rate of operation, and to reduce the occurrence of postoperative complications.