彩色多普勒超声在终末期肾病患者自体动静脉内瘘术前评估及术后监测中的应用

doi:10.6040/j.issn.1671-7554.0.2018.097

摘要/Abstract

摘要： 目的探讨彩色多普勒超声在自体动静脉内瘘术前评估及术后监测中的应用。方法回顾性分析2016年1月1日至2017年12月31日山东大学齐鲁医院行自体动静脉内瘘手术终末期肾病患者312例临床资料。根据有无术前彩色多普勒超声评估分为评估组和未评估组,比较两组手术成功率及手术时间;评估组术前、术后均使用彩色多普勒超声观察桡动脉及头静脉内径、血流情况。统计分析检测结果。结果评估组手术成功率明显高于未评估组(99.27% vs 93.71%),差异有统计学意义(P=0.01),手术时间明显低于未评估组［(52.55±16.35)min vs(65.40±20.25)min］,差异有统计学意义(P<0.001)。评估组术后桡动脉内径［(0.28±0.03)cm vs(0.20±0.03)cm］及血流量［(348.49±64.59)mL/min vs(90.04±61.05)mL/min］较术前明显提高,差异有统计学意义(P<0.001);评估组术后头静脉内径［(0.33±0.05)cm vs(0.21±0.04)cm］及血流量［(537.88±102.53)mL/min vs(25.38±18.51)mL/min］较术前明显提高,差异有统计学意义(P<0.001)。结论彩色多普勒超声可指导自体动静脉内瘘术前评估,提高手术成功率、缩短手术时间,可监测手术前后血管内径和血流情况,评估内瘘功能。

关键词: 彩色多普勒超声, 动静脉内瘘, 终末期肾病, 血液透析

Abstract: Objective To explore the application value of color Doppler flow imaging(CDFI)in the establishment and evaluation of autogenous arteriovenousfistula(AVF). Methods Theclinical data of 312 patients undergoing AVF during Jan.1, 2016 and Dec.31, 2017 were retrospectively analyzed. According to whether these patients received preoperative CDFI examination,they were divided into the CDFI group and non-CDFI group. In the CDFI group, the diameter and blood flow of the radial artery and cephalic vein were evaluated before and after surgery. The success rate and operation time of the two groups were compared. Results The success rate of surgery was significantly higher in the CDFI group than in the non-CDFI group(99.27% vs 93.71%, P=0.01), while the operation time was markedly shorter ［(52.55±16.35)min vs(65.40±20.25)min, P<0.001］. In the CDFI group, after operation, the diameter of the radial artery ［(0.28±0.03)cm vs(0.20±0.03)cm］and blood flow ［(348.49±64.59)mL/min vs(90.04±61.05)mL/min］, and the diameter of the cephalic vein ［(0.33±0.05)cm vs(0.21±0.04)cm］ and blood flow ［(537.88±102.53)mL/min vs(25.38±18.51)mL/min］were significantly improved(all P<0.001). Conclusion Preoperative CDFI can promote the success rate, and shorten the operation time of AVF. Early postoperative CDFI can detect the diameter of blood vessels and blood flow toevaluate AVF function.

Key words: Color Doppler flow imaging, Autogenous arteriovenous fistula, Uremia, Hemodialysis

中图分类号:

R445.1

冯静静,张鲁伟,赵鹏,郭宁,田军,崔先泉. 彩色多普勒超声在终末期肾病患者自体动静脉内瘘术前评估及术后监测中的应用[J]. 山东大学学报 (医学版), 2018, 56(7): 65-69.

FENG Jingjing, ZHANG Luwei, ZHAO Peng, GUO Ning, TIAN Jun, CUI Xianquan. Application of CDFI in the establishment and evaluation of autogenous arteriovenousfistula[J]. Journal of Shandong University (Health Sciences), 2018, 56(7): 65-69.

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