血液透析動靜脈瘻管檢查新趨勢之介入性瘻管整型術

The Arterio-Venous Fistula Checkup and New Tendency of Hemodialysis-Interventional Angioplasty of Arterioenous Fistula

良好的洗腎動靜脈瘻管的養護可以延長動靜脈瘻管的使用期限，減少洗腎息者因動靜脈瘻管併發症而提升的住院率，進而可以降低整體醫療費用的支出。所謂的動靜脈瘻管整型術，乃是經由血管穿刺，將介入性的導線經由血管傳送至病灶點，再將導管汽球沿著導線到達病灶點的狹窄處，透過適當時問的充氣加壓，將病灶點的狹窄擴張，以期改善狹窄程度。一般而言，自體瘻管的平均使用年限是3年，而人工瘻管則是2-3年。因而如何早期找出瘻管功能異常，並以瘻管整型術予以治療，以延長瘻管使用年限，減少患者洗腎瘻管的併發症及住院率，進而減少整體醫療費用的支出，則是未來動靜脈瘻管照護團隊所需共同努力的目標。

Good maintenance for arterio-venous fistula after hemodialysis not only prolongs their wear-ability, but also reduces the possibility of hospitalization for the hemodialysis patients due to the complications of the fistula, then deceases the overall expenditure of medical care. The alleged 'angioplasty of arteriovenous fistula' means to use an interventional wire to pass the stenotic point and push the balloon to follow the wire to reach the much stenotic symptomatic points, then extend these points by optimal pressure of nitrogen for some time so as to improve the level of narrowness. Generally speaking, the average service life of fistula itself is about three years, and that of the artificial fistula two-three years. Therefore, finding any dysfunction of the fistula as soon as possible and reducing the possibility of hospitalization as well as overall medical expenditures would be the imperative goal for medical care teams of arterio-venous fistula in the future.