彩色多普勒超声评估行高位动静脉内瘘术及静脉浅置化患者血管的价值

To Value the Color Doppler Ultrasonography in high Arteriovenous Fistula and Venous Shallow

目的：采用彩色多普勒超声评估行上臂高位动静脉内瘘吻合术及静脉浅置化的终末期血液透析患者的血管情况。方法：选择103例行高位动静脉内瘘术的终末期肾病血液透析患者,术前超声检查选择适宜的血管,对血管距皮肤〉6.0 mm的病例进行静脉浅置化定位,术后观察动静脉内瘘的成熟度及并发症。结果：103例患者均成功进行内瘘手术,其中有67例高位内瘘术后行静脉浅置化,术后2月内观察血管情况良好;血液透析后6月~5年部分患者出现并发症,其中11例血栓形成,6例静脉瘤样扩张,17例静脉局部狭窄。结论：彩色多普勒超声对高位动静脉內瘘术患者选择造瘘血管、静脉浅置化和术后监测血管通路有重要的临床应用价值。

Objective： To evaluate the vascular conditions of patients with end-stage renal disease and hemodialysis who underwent upper arm high arteriovenous fistula anastomosis and venous shallow by Color Doppler ultrasonography. Methods： 103 cases of patients with end-stage renal disease and hemodialysis undergoing upper arm high arteriovenous fistula anastomosis and venous shallow vein were enrolled in the study. Preoperative ultrasound was used to select appropriate blood vessels and localize venous shallow in patients with distance from vein to skin 6 mm. The maturity and complication of arteriovenous fistula were observed after operation. Results： 103 cases were successfully performed to internal fistula operation,of which 67 cases of high internal fistula underwent venous shallow operation. 2 months after operation the vascular condition was good. Complications occurred in some cases of patients 6 months to 5 years after hemodialysis,of which there were 11 cases of thrombosis,6 cases of venous tumor like dilatation,17 cases of venous stenosis. Conclusio： Color Doppler ultrasound has an important clinical application value in the selection of fistula vessels,venous shallow and postoperative monitoring of the vascular access in patients with high internal arteriovenous fistula.