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目的探讨远红外线(FIR)照射对动静脉内瘘(AVF)狭窄行经皮腔内血管成形术(PTA)后的远期保护作用。方法选择2014年1月至2016年1月武汉市第一医院行PTA治疗的维持性血液透析患者23例,其中男性15例,女性8例;年龄34~76岁,平均年龄60.3岁。行PTA手术,对照组术后采用常规方法治疗,观察组在常规治疗基础上加FIR照射。比较2组术后1、3、6、12个月AVF功能及通畅率,超声测量比较观察组术后1、3、6、12个月狭窄处血管壁厚度及内径。结果 23例患者中22例手术成功,成功率95.7%。再排除1例因脑血管意外死亡,实际参与研究的患者对照组11例,观察组10例。术后6个月与12个月观察组血管通路通畅率明显优于对照组(90.0%vs 36.4%、70.0%vs 18.2%;P<0.05)。术后1、3、6、12个月观察组狭窄处血管壁厚度及内径变化比较,差异无统计学意义(P>0.05)。结论初步研究表明,持续FIR照射可抑制PTA术后扩张的静脉血管收缩,改善血管内皮细胞功能,抑制内膜增生,提升PTA术后AVF远期通畅率。
Objective To investigate the long-term protection effect of far infrared ray (FIR) irradiation on stenosis of arteriovenous fistula (AVF) after percutaneous transluminal angioplasty (PTA). Methods Twenty-three patients with maintenance hemodialysis underwent PTA from January 2014 to January 2016 in Wuhan First Hospital, including 15 males and 8 females, aged 34-76 years (mean age 60.3 years). The patients underwent PTA surgery. The control group was treated by conventional method. The observation group was given FIR irradiation on the basis of routine treatment. AVF function and patency rates were compared between the two groups at 1, 3, 6 and 12 months after operation. The thickness and internal diameter of the vessel wall in the observation group at 1, 3, 6 and 12 months after operation were compared by ultrasound. Results Of the 23 patients, 22 had successful operation, with a success rate of 95.7%. And then exclude 1 case of cerebrovascular accidental death, the actual participation of patients in the control group of 11 patients, the observation group of 10 patients. Patency rates of vascular access in observation group 6 months and 12 months after operation were significantly better than those in control group (90.0% vs 36.4%, 70.0% vs 18.2%; P <0.05). There was no significant difference in the changes of vascular wall thickness and internal diameter at 1, 3, 6 and 12 months after operation in the observation group (P> 0.05). Conclusion Preliminary studies have shown that continuous FIR irradiation can inhibit the dilatation of venous vasoconstriction after PTA, improve endothelial cell function, inhibit intimal hyperplasia, and improve long-term patency of AVF after PTA.