彩色多普勒超声对血液透析血管的评估价值探讨

Study on the clinical value of color Doppler sonography in hemodiafiltration vessels

目的探讨血管超声对自体动静脉造瘘术前评估及术后随访的临床价值。方法采用GE Vivid 7Dimen-sion彩色多普勒对50例患者进行上肢血管超声检查,其中拟行自体动静脉造瘘的患者30例,已造瘘患者20例,总结造瘘超声术前评估及术后随访结果,并制定超声对造瘘血管的评估标准。结果①术前评估血管中,桡动脉管壁弥漫性钙化2例,头静脉内径过细(1.4mm)1例,均放弃桡动脉-头静脉造瘘,余者均成功行造瘘术;②20例造瘘术后随访患者,1例因静脉瘤样扩张并前臂明显水肿,2例因血栓形成使管腔明显狭窄,导致血流量不足。结论通过血管超声对自体动静脉造瘘的术前评估及术后随访,可提高造瘘成功率,并及时发现造瘘术后的并发症,有很好的临床应用价值。

Objective To study the clinical value of color Doppler sonography on preoperation evaluation and postoperation follow-up of arteriovenous fistulization. Methods The 50 patients were examined with the color Doppler sonography by GE Vivid 7 Dimension machine, 30 patients for preoperation evaluation of arteriovenous fistulization, 20 patients for postoperation of arteriovenous fistulization. The sonography features were summarized, the evaluation standard of vessel ultrasound was formulated. Results @ In the preoperation evaluation, three patients finally gave up the arteriovenous fistulization, 2 cases presented vessel wall calcification of radial artery, and 1 case of thin cephaic vein （〈1.5 mm） ; （2） In 20 patients for postoperation of arteriovenous fistulization, one case appeared cephalic venous aneurysm and edema of forearm and two cases with blood vessel stenosis because of thrombosis, which led to blood flow insufficiency. Conclusion The vessel ultrasound has important value on preoperation evaluation and postoperation follow-up of arteriovenous fistulization. According to the vessel ultrasound, the achievement ratio of arteriovenous fistulization can be improved, and the complication of postoperation can be found promptly.