彩色多普勒超声在老年透析患者自体动静脉瘘术后评价中的价值

Evaluation of color Doppler ultrasound on postoperative autologous arterio-venous fistula in elderly dialysis patients

目的探讨彩色多普勒超声在老年终末期肾病患者自体动静脉内瘘(AVF)术后的临床应用价值。方法对2010年12月至2014年10月106例终末期肾病患者按年龄进行分组,老年组(≥60岁)81例和对照组(<60岁)25例,其中老年组患者平均年龄(68.3±7.3)岁,对照组(45.1±5.2)岁。对两组患者AVF术后瘘口发育、并发症、血流参数等进行观察总结,并进行统计学对比分析。结果老年组AVF术后瘘口成熟不良等并发症发生率[19.75%(16/81)]明显高于对照组[8.00%(2/25)],差异有统计学意义(P<0.05)。与术前比较,老年组与对照组术后2、3、6个月头静脉内径、瘘口血流量均有增加,但老年组较对照组增加缓慢,差异有统计学意义(P<0.05)。结论彩色多普勒超声是监测AVF的重要检查手段,对延长瘘口使用时间及提高血液透析患者生活质量有重要实际价值。

Objective To investigate the clinical application value of color Doppler ultrasound in postoperative arterio-venous fistula（AVF） in elderly end stage renal disease（ESRD） patients. Methods 106 cases of ESRD from December 2010 to October 2014 were divided into the elderly group（≥60 years old, 81 cases） and the control group（〈60 years old,25 cases） according to the age,in which the elderly group had the average age of（68.3±7.3） years old and the control group had the average age of（45.1±5.2） years old. The fistula orifice development,complications and bloodstream parameters after AVF operation were performed the observation and summary. The statistical contrastive analysis was conducted. Results The occurrence rate of complications such as fistula orifice dysmaturity in the elderly group was 19.75%（16/81）,which was significantly higher than 8.00%（2/25）in the control group,the difference was statistically significant（P〈0.05）. Compared with before operation,the cephalic vein diameter and fistula orifice blood flow volume at 2,3,6 months in the two groups were increased, but the increase in the elderly group was slower than that in the control group,the differences were statistically significant（P〈0.05）. Conclusion Color Doppler ultrasound is an important examination means to monitor AVF and has an important practical value to prolong the use time of fis-tula and improve the quality of life in elderly dialysis patients.