自体动静脉内瘘手术前后的超声评价

Ultrasonic evaluation of arteriovenous fistula before and after operation

目的评价术前超声检查对行自体桡动脉头静脉端侧吻合术患者术后内瘘成功率的影响。方法选取在我院行自体桡动脉头静脉端侧吻合术的57例尿毒症患者,将其随机分组,其中30例行术前血管超声检查(超声组)评估桡动脉和头静脉造瘘血管条件;27例仅行物理检查(对照组)。术后1￣6个月对两组患者均采用超声检查方法进行评估,主要观察血管走行、内径及血流通畅情况,比较两组内瘘术后成功率。结果超声组内瘘术后成功率83.3%,对照组内瘘术后成功率74.1%,两组比较差异有统计学意义(P<0.05)。结论超声检查不仅能对自体动静脉内瘘术后血管状况进行评价,且能对术前桡动脉和头静脉等造瘘血管条件进行详细评估,以确立内瘘手术适应证和最佳手术部位,减少手术的盲目性,降低内瘘术后失败率。

Objective To evaluate the effect of preoperative ultrasonography on success rate of arteriovenous fistula after radio-cephalic end-to-lateral anastomosis operation. Methods Fifty-seven patients with uremia all accepted the operation of radio-cephalic end-to-lateral anastomosis on wrist, 30 cases of them were chosen randomly to receive ultrasound examination （examination group）and the other 27 cases received physical examination only （contral group）. All cases received ultrasonography 1 -6 months after the operation, the course, the internal diameter, and the patency of the blood vessels were observed. The success rate after operation was compared. Results The success rate of operation was higher in examination group （83.3%） than that in contral group （74.1% ）, there was significant difference between two groups （P 〈 0.05 ）. Conclusion Uhrasonography can not only evaluate the blood vessels after operation, but also evaluate the condition of radial artery and cephalic vein before operation, determine the indications of operation and best operation position, decrease the blindness and failure rate of operation.