双重麻烦:关于中央静脉双重狭窄的病例报告
Yana Supriatna1, Trianingsih1, Rifki Bachtiar1
1Department of Radiology, Faculty of Medicine, Public Health, and Nursing, Universitas Gadjah Mada, Farmako Sekip Utara Street, Yogyakarta, 55281, Indonesia.
Radiology case reports
|December 9, 2025
概括
血液透析患者中枢静脉狭窄的诊断可能具有挑战性. 程序前计算机断层扫描血管造影 (CTA) 对于全面的评估和治疗计划至关重要,特别是当超声波有局限性时.
科学领域:
- 血管外科 血管外科
- 腎臟病學 (nephrology) 是一種醫學專業.
- 放射学 放射学是一门学科.
背景情况:
- 中枢静脉狭窄是慢性病 (CKD) 患者接受血液透析的常见并发症.
- 它通常是由于长时间使用中央静脉导管和重复刺穿而导致的,导致纤维化和狭窄.
- 诊断工具包括计算机断层扫描血管学 (CTA),超声波学和常规静脉学.
研究的目的:
- 为了突出诊断挑战和治疗影响中枢静脉狭窄在血液透析患者.
- 强调术前成像对于准确的评估和规划的重要性.
主要方法:
- 一个75岁的男性CKD患者的病例介绍,他的左臂在左下关节静脉皮肤透光血管成形术 (PTA) 后胀.
- 最初的评估依赖于超声波由于财务限制,其次是静脉图显示复缩.
- 进行了重复的PTA,随后进行了进一步的静脉检查,以确定通过大腿部方法治疗的近端病变.
主要成果:
- 最初的PTA成功治疗了复缩,但确定了次要的近位病变.
- 通过大腿靠近的第二次PTA成功扩大了二次损伤.
- 缺乏手术前的CTA使静脉病理的完全划分变得复杂.
结论:
- 超声波在检测难以进入地区的狭窄症方面存在局限性.
- 术前计算机断层扫描血管图 (CTA) 对于中央静脉狭窄的全面评估和有效治疗规划至关重要.
- 准确的成像对于成功管理血液透析相关的中央静脉狭窄至关重要.
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