尿毒症患者血管内瘘手术前后的彩超观察

The observe of color doppler before and after fistula surgery in uremic patients.

目的研究彩色多普勒下桡动脉及头静脉内径,吻合口大小对内瘘流量的影响。方法 15例慢性肾功衰尿毒症患者,行动静脉内瘘术前通过彩超检测前臂远端桡动脉及头静脉内径及最大流速。术中测量桡动脉、头静脉内径及动脉开窗长度。术后4周彩超检测桡动脉及头静脉内径及最大流速;内瘘内径、血流量。分析上述参数与血流量的关系。结果 15例慢性肾功衰患者男9例,女6例,年龄(52.0±14.89)岁。彩超检查桡动脉及头静脉内径术后较术前明显增粗。术中测量的桡动脉及头静脉内径与术前超声检查无差异。术后4周超声检查内瘘口内径与内瘘血流量有很好的正相关。术中动脉切口与超声下内瘘血流量无相关性。结论本研究通过术中测量桡动脉及头静脉内径与术前超声检查结果 ,提示内瘘手术前可通过彩色超声检查来评估桡动脉及头静脉情况,指导临床医师实施内瘘手术,术后4周彩超检测内瘘内径可预测血管内瘘手术的成功率。

Objective To study the relationship between Cephalic vein diameters,Radial artery diameter and the size of Anastomotic under high frequency color doppler and the fistula blood flow.Methods 15 uremic patients were enrolled;forearm radial artery diameter,cephalic diamer and maximum blood flow were measured by high frequency color doppler before surgery.Radial artery diameter,cephalic vein diameter and the window size of the artery was measured during the surgery.Radial artery diameter,cephalic vein diameter and maximum blood flow was measured by high frequency doppler 4 weeks after the surgery.The relationship between these parameters and blood flow were analyzed by SPSS 11.5.Results 15uremic patients（9M,6F,age 52.0±14.89years）were enrolled,diameter of Radial artery and cephalic vein of witch enlarged 4 weeks after surgery.There was no difference in the diameters between before and during the surgery.The size of the fistula correlated positively with blood flow 4 weeks after surgery.There was no relationship between anastomotic size and blood flow.Conclusion High frequency doppler can primary evaluate the vessel conditions before surgery and may be guidance for a doctor to practice fistula surgery,the size of fistula under color doppler can predict the successful rate of fistula surgery.