血液透析患者动静脉通路彩色多普勒超声监测100例分析

Clinical Value of Color Doppler Ultrasonography on Monitoring of Arteriovenous Channel in 100 Cases of Blood Dialysis

目的:探讨对血液透析患者进行动静脉通路彩色多普勒超声(CDUS)观察和监测的价值。方法:对100例血液透析患者的动静脉内瘘进行超声检查,分析结果并总结其临床应用价值。结果:100例患者中,72例未见异常;28例异常者中血管狭窄21例,内瘘头静脉端闭塞2例,头静脉近吻合口处斑块形成3例,内瘘量明显增大伴心衰症状1例,静脉炎1例。21例血管狭窄者中13例伴血栓形成,4例伴静脉瘤样扩张及血栓形成,1例伴离心血流的侧支循环开放致手臂肿胀,1例手臂肿胀者超声可见段血管通路未见狭窄,经CTA证实为内瘘侧头臂静脉狭窄,余2例为单纯性血管狭窄。结论:作为监测血液透析通路的辅助检查方法之一,彩色多普勒超声可评估血管通路功能,及时发现有或无临床症状的相关并发症,协助临床医师制定治疗方案,评估治疗后效果,发挥着重要的临床意义。

Objective： To investigate the clinical value of Color doppler ultrasonography on monitoring of arteriovenous channel in 100 cases of blood dialysis. Methods： 100 patients with arteriovenous fistula（ AVF） for blood dialysis were examined with ultrasonography. The results were analysed and the value of ultrasonography on AVF were evaluated. Results： Among the 100 patients,there was no significant complication in 72 patients; in 21 patients were with stenoses; in 17 patients were accompanied with thrombs; 4 patients were accompanied with dilatation of the vessels; 1 patient was accompanied with centrifugal collateral circulation and arm turgidity; 1 patient was accompanied with internal fistula side head arm vein stenosis and arm turgidity confirmed by CTA but there was not fundby ultrasonography; 2 patients were only blood vessel stenosis; 3 patients were found plaques in the cephalic vein near the anastomosis; 1 patient had heart failure caused by the increased blood flow; 1 patient had phlebitis. Conclusion： As a kind of methods for monitoring vascula access,CDUS provides an important information of AVF＇s function and complications of symptom accompanied with or not,can guide the clinical treatment and evaluate the effects in time.