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相關文獻
- Directional Atherectomy for Vascular Access Salvage in Chronic Hemodialysis Patients
- The Survey of the Life Span of Vascular Access for Patients with Diabetes on Hemodialysis
- 血液透析病患動靜脈瘻管使用年限與PTA治療之分析
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- Percutaneous Transluminal Angioplasty for Dysfunctioned Vascular Access in Chronic Hemodialysis Patients
- 概觀血液透析之血管通路
- 血管通路功能不良的病理機轉
- 血管通路栓塞的危險因子與預防
- 血液透析的經皮血管通路
頁籤選單縮合
題 名 | Directional Atherectomy for Vascular Access Salvage in Chronic Hemodialysis Patients=在長期血液透析病患使用粥塊切除術挽救血管通路之經驗 |
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作 者 | 江守山; 洪惠風; 張宗興; | 書刊名 | 臺灣腎臟醫學會雜誌 |
卷 期 | 15:1 2001.03[民90.03] |
頁 次 | 頁9-13+35 |
分類號 | 415.816 |
關鍵詞 | 血管通路; 血液透析; 血管成形術; Vascular access; Hemodialysis; Angioplasty; Directional atherectomy; |
語 文 | 英文(English) |
中文摘要 | 血管通路是血液透析患者的生命線,為了維持血管通路的功能與通暢,常常須使用經放皮穿腔血管成形術(percutaneous balloon angioplasty)簡稱(PTA)。但是血管經PTA後有容易再狹窄,有的狹窄處即使用到最大的壓力仍無法撐開等決點。Directional atherectomy (DA) 當除是為了冠狀動脈狹窄而開發,DA依學理可以使用原本無法撐開的血管內徑增加,也許對於再狹窄的發生率有不同的影響,但是DA使用於血液透析病人血管通路的安全性仍未經適當的評估。本研究乃將二十個血液透析患者依血管通路開立時間長短配對後,隨機分配成兩組各十個人,研究組先使用DA後在使PTA將血管擴充,而對照組則僅使用PTA。在術後兩組皆使用相同的血管通路監測方式,如果有問題的血管就經再次的PTA。兩組病患在糖尿病比例、血管通路位置、抽煙、EPO的使用、性別、既住血塊摘除術的病史、靜脈壓、年齡、總膽固醇、三酸甘油酯、血紅素、鐵蛋白和攜鐵蛋飽和度等均無統計學上有意義的分別。到第二年滿經協助後的血管暢通率在兩組分別是實驗組100%而對照組84%,兩組的血管存活率並無統計上有意義的差別。兩組用來維持血管暢通的PTA次數皆分別是實驗的15次與對照組的19次(p=0.506)。總而言之,本研究認為對於有狹窄的血液透析血管通路,DA輔以PTA能達到與只使用PTA一樣的療效與相同的安全性。 |
英文摘要 | The site of vascular access is invaluable for hemodialysis patients. To maintain the vascular access, PTA (percutaneous transluminal angioplasty) has some drawbacks. Directional atherectomy (DA) was developed for coronary artery disease as PTA. DA intervention has some theoretical benefit but its safety in hemodialysis vascular access need further investigation. We had 20 patients with matched shunt age randomized into two groups, one for DA + PTA and the other PTA only for control group. Both groups were followed by the same surveillance program after the procedure. The patients with abnormal findings in the surveillance program underwent digital subtraction angiography and then PTA if necessary. There was no statistical difference in baseline data including DM, sites of access, smoking, EPO usage, sex, type of access, thrombectomy history, high venous pressure, age, total cholesterol, triglyceride, hemoglobulin, ferritin and transferring saturation. There is no statistical difference in vascular assess survival. The PTA needed to maintain the access were 9 in DA group and 6 in PTA only group. (p =0.506). in conclusion, directional atherectomy, adjuvant by PTA, is safe and also as effective as PTA alone in treating failing vascular access. |
本系統中英文摘要資訊取自各篇刊載內容。