彩色多普勒超声检测糖尿病肾病血液透析患者动静脉内瘘血管情况观察

Color Doppler ultrasound monitoring vascular conditions observed within the fistula in patients with diabetes

目的探讨和分析使用彩色多普勒超声检测糖尿病肾病血液透析患者自体动静脉内瘘血管建立的过程及其相关变量。方法选择需要进行血液透析的终末期肾病患者100例,其中糖尿病患者50例作为观察组,非糖尿病患者50例作为对照组,两组患者均应用彩色多普勒超声检测自体动静脉造瘘术前后血管的情况,并分析和比较两组临床效果、术后1 d1、w、3 w、4 w及半年瘘口内径和血流量。结果两组患者动静脉内瘘术均成功,且血流通畅,无并发症出现,术后超声图像表现为桡动脉内为红色搏动性层流,近瘘口处血流加快,阻力降低,瘘口处为五彩镶嵌血流,头静脉呈动脉化频谱;观察组瘘口内径术后1 d、1 w与对照组相比,差异均不具有统计学意义(P>0.05)3,w4、w及半年与对照组相比,观察组明显低于对照组,差异有统计学意义(P<0.05);观察组动静脉血流量术后1 d、1 w与对照组相比,差异均不具有统计学意义(P>0.05),3 w4、w及半年与对照组相比,对照组明显优于观察组,差异具有统计学意义(P<0.05)。结论彩色多普勒超声检测糖尿病患者自体动静脉内瘘口内径和血流量均小于非糖尿病患者,提示在动静脉内瘘术后糖尿病患者自体动静脉内瘘血管建立和成熟时期较非糖尿病患者更长,是临床值得注意的问题。

Objective： To explore and analyze the use of color Doppler ultrasound monitoring diabetic patients with arteriovenous fistula from the blood vessels to establish the process and its related variables.Methods：The 50 patients with diabetes were selected as the observation group,and 50 patients as non-diabetic control group,both of which were monitored by color Doppler ultrasound before and after autologous arteriovenous fistulization blood vessels,and the clinical results of the two groups and the fistula diameter and blood flow after the operation in 1d,1,3,4 w and six-month were analyzed and compared.Results：Two groups of patients with arteriovenous fistulas were successful with the smooth blood flow and had no complications.The postoperative ultrasound images showed the radial artery as a red pulsating laminar flow,the blood flow near the fistula was faster,the resistance decreased,and the fistula had colorful mosaic blood flow and cephalic vein was arterialized spectrum.Compared with the control group,differences were not statistically significant in the observation group after fistula diameter operation in 1d,1w,（P0.05）.Compared to with the control group,the observation group was significantly lower than the control group in 3,4 w and half a year,and the difference was statistically significant（P0.05）;compared with the control group,the differences in the observation group arterial and venous blood flow after 1d and 1w were not statistically significant（P0.05）;the control group was significantly better than the observation group,and the difference in 3,4 w and six months were statistically significant（P0.05）.Conclusion：The autologous arteriovenous fistula diameter and blood volume are less with color Doppler ultrasound monitoring diabetic patients than those with the non-diabetic patients,suggesting autologous arteriovenous fistula creation and maturation in the arteriovenous fistula are longer in the patients with diabetes than those with non-diabetic patients,which is clinically noteworthy.