高频彩超在尿毒症患者动静脉内瘘术前的应用

Application of high frequency color Doppler to arteriovenous fistula operation for hemodialysis in uremic patients

目的探讨高频彩超在动静脉内瘘术前目标血管的筛选、定位的意义。方法选择克拉玛依市中心医院68例须行动静脉内瘘术的尿毒症患者随机分为A、B两组,应用高频彩超对A组患者分别于动静脉内瘘术前目标血管进行了检测筛选,根据筛选、定位的目标血管进行手术,B组按照传统方法选择目标血管进行手术,术后一个月末应用高频彩超对A、B两组内瘘通道功能、成熟的进行评价。结果在A组36例待透析患者中非惯用手臂头静脉和桡动脉可用为目标配对血管30例,占83.3%。不可用目标配对血管数6例,占16.7%。A组较B组平均手术切口减小,P<0.05;时间缩短,P<0.05;一月末内瘘成熟率明显提高,P<0.05;早期血栓形成明显减少,P<0.05。结论应用无创性的高频彩超技术是动静脉内瘘术前选择目标血管的一种良好方法。

Objective To study high frequency color Doppler in the selection and localization of the vessels suitable for internal arteriovenous fistula operation. Methods We recruited 68 uremic patients who needed the operation of internal arteriovenous fistula, and assigned them randomly into two groups. The target vessels for internal arteriovenous fistula operation were selected and localized by high frequency color Doppler in group A patients and by the routine method in group B patients. After one month of the operation, function and maturation of the internal fistula were evaluated by high frequency color Doppler examination. Results In group A, the cephalic vein and radial artery in the forearm at non-preference side could be matched for fistula operation in 30 of the 36 cases （83.3%）. In comparison with group B, patients in group A had smaller incision, less operation time, higher maturation rate for use after operation for one month and less thrombosis in the earlier period （P〈0.05）. Conclusion High frequency color Doppler examination is a useful method for the selection of vessels for internal arteriovenous fistula operation for hemodialysis in uremic patients.