超声技术对血液透析用动静脉内瘘的临床应用现状与前景

Current status and prospect of clinical application of ultrasound technology in arteriovenous fistula for hemodialysis

目的动静脉内瘘(AVF)是终末期肾病(ESRD)患者进行维持性血液透析(MHD)治疗的首选血管通路,其建立前的血管选择与评估、建立后的是否成熟评估、成熟障碍的及时处理、开始使用后并发症的及时监测、定位与处理,对于进行MHD治疗均至关重要。超声技术在评估血管解剖结构及血流情况方面,具有便捷、无创、安全、经济等优势,有助于选择造瘘血管、评估AVF成熟度、发现AVF成熟障碍及其原因、检测和定位术后并发症、指引成熟障碍及并发症的治疗、提高AVF的建立成功率、保证MHD的顺利进行。本文综述了近年来常规超声和超声造影技术在MHD患者AVF方面临床应用的现状与前景。

Arteriovenous fistula(AVF)is the preferred vascular access for maintenance hemodialysis(MHD)in patients with end-stage renal disease(ESRD).The vascular selection and evaluation before AVF establishment,the maturity assessment after AVF establishment,the timely treatment of AVF mature disorders,and the timely monitoring,location,and treatment of complications during AVF use,are all crucial for the MHD treatment.Ultrasound has the advantages of convenience,non-invasiveness,safety,and economy in evaluating vascular anatomy and blood flow,and is helpful for selecting AVF vessels,assessing the maturity of AVF,discovering the AVF maturity disorders and their causes,detecting and locating postoperative complications,guiding the treatment of mature disorders and complications,improving the success rate of AVF establishment,and ensuring the proceeding of MHD.This article reviewed the current status and prospect of the clinical application of conventional ultrasound and contrast-enhanced ultrasound(CEUS)in the AVF of MHD patients in recent years.