HUANG Ruo,WANG Lyuping,ZHANG Jianna, et al. The clinical observation of the local directly punctures to improve the arteriovenous internal fistula stenosis in the blood dialysis[J]. JOURNAL OF WEZHOU MEDICAL UNIVERSITY, 2017, 47(8): 615-617.
Abstract： Objective: To investigate the effects of local puncture in treatment of arteriovenous internal fistula stenosis in hemodialysis patients. Methods: Thirty nine arteriovenous fistula stenosis cases from January 2012 to January 2016 in the First Affiliated Hospital of Wenzhou Medical University were included. In order to expand blood vessels, 16 g needles were used to puncture in the narrowest site of the fistula and separate blood vessels within the organization, with thrombolysis being used on thrombosis patients. Every time before puncture, the fistula was evaluated and touched. Whenever hemodialysis was conducted, the above puncture procedures would be repeated and internal fistula stenosis was observed. Results: Twenty-seven of 39 cases were effective treatment, and 12 cases were invalid. The treatment was more effective with patients whose narrow fistula sites were less than two and those whose stenosis length was shorter than 1 cm (χ2=14.745, 8.269, P<0.01). The blood flow increased and venous pressure decreased in patients of effective treatment after puncture (t=-9.251, 8.628, P<0.01). That the time of puncture on those patients was 8.6±3.8. Nine of the 27 effective cases showed vascular expansion and disappearance of stenosis after the puncture; another 13 cases with two narrow sites showed increased blood flow and deereading of the venous pressure that 5 cases with three narrow sites, including one thrombosis patient whose stenosis almost disappeared after thrombolysis and repeated punctures, showed dropping of the venous pressure. Nine of the 27 cases were seen noticeable shrinking aneurysm; 5 cases were reported disappearance of local sites pains and 3 cases reported pain relief. Twelve patients with invalid treatment turned to fistula rebuild or balloon expansion. Conclusion: Local puncture in short-term fistula within narrow place can expand local blood vessels, prevent and treat arteriovenous fistula in vascular stenosis, reduce the patients pain and economic burden, be convenient and feasible.
