透析患者中心静脉狭窄或闭塞的腔内治疗进展
Progress of Endovascular Treatment for Central Venous Stenosis or Occlusion in Hemodialysis Patients
DOI: 10.12677/acm.2025.1551420, PDF,   
作者: 李新宇*, 付利锋, 陈居正：赣南医科大学第一临床医学院，江西 赣州；方萃福#：赣南医科大学第一附属医院血管外科，江西 赣州
关键词: 血液透析；中心静脉狭窄；腔内治疗；血管；Hemodialysis； Central Venous Stenosis； Endovascular Treatment； Vascular
摘要: 中心静脉疾病是维持性血液透析患者血管通路的严重并发症之一，以中心静脉狭窄或闭塞(Central venous stenosis/occlusion, CVS/O)为主要病理表现。CVS/O可通过引发静脉高压综合征破坏血管通路完整性，显著降低透析充分性并缩短患者总体透析龄。目前，以经皮腔内血管成形术(Percutaneous transluminal angioplasty, PTA)及支架置入术(Stent placement)为核心的血管内介入治疗已成为临床一线治疗方案。尽管腔内治疗能有效恢复短期静脉通畅性并改善通路功能，但术后再狭窄问题仍严重影响远期疗效。本文系统综述CVS/O腔内治疗的技术进展与循证证据，探讨现存挑战及未来研究方向。
Abstract: Central venous disease, manifesting as stenosis or occlusion (CVS/O), represents a critical complication of vascular access in hemodialysis patients. CVS/O can induce severe venous hypertension, compromise vascular access integrity, reduce dialysis adequacy, and shorten overall dialysis vintage. Endovascular interventions, including percutaneous transluminal angioplasty (PTA) and stent placement, are currently first-line therapies. While these minimally invasive approaches effectively restore short-term venous patency and improve access functionality, the persistent challenge of restenosis significantly compromises long-term outcomes. This review synthesizes recent technological advancements and evidence-based practices in endovascular management of CVS/O, while addressing current limitations and future directions.
文章引用：李新宇, 付利锋, 陈居正, 方萃福. 透析患者中心静脉狭窄或闭塞的腔内治疗进展[J]. 临床医学进展, 2025, 15(5): 668-673. https://doi.org/10.12677/acm.2025.1551420

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