彩色多普勒超声在血液透析患者上肢动静脉内瘘成形术中的应用价值

The value of color Doppler ultrasound in the treatment of upper extremity arteriovenous fistula in hemodialysis patients

目的探讨彩色多普勒超声检查在血液透析患者上肢动静脉内瘘成形术中的应用价值.方法对61例血液透析终末期肾病患者行彩色多普勒超声检查,统计自体动静脉内瘘并发症状况,并比较不同自体动静脉内瘘情况患者阻力指数、收缩期峰值流速.结果本组患者中,自体动静脉内瘘通畅38例(62.3%),出现并发症23例(37.7%),其中血栓形成12例,内瘘狭窄4例,头静脉瘤样扩张3例,血肿形成2例,盗血综合征2例.自体动静脉内瘘通畅患者吻合口及桡动脉收缩期峰值流速显著快于自体动静脉内瘘并发症患者(P<0.01);不同自体动静脉内瘘患者阻力指数比较差异无统计学意义(P>0.05).结论彩色多普勒超声检查能准确评估血液透析患者上肢动静脉内瘘形成的血管通畅情况,值得在临床推广应用.

Objective To evaluate the value of color Doppler ultrasound in the treatment of upper extremity arteriovenous fistula in hemodialysis patients.Methods A total of 61 patients with hemodialysis endstage renal disease underwent color Doppler ultrasonography.The complications of autologous arteriovenous fistula were counted,and the resistance index and peak systolic velocity of patients with autologous arteriovenous fistula were compared.Results In this group of patients,autologous arteriovenous fistula was unobstructed in 38 cases(62.3%),and complications occurred in 23 cases(37.7%),including 12 cases of thrombus,4 cases of internal stenosis,3 cases of cephalic vein tumor expansion,2 cases of hematoma and 2 cases of steal syndrome.The peak velocity of anastomotic and brachial artery systolic in patients with autologous arteriovenous fistula was significantly faster than that in patients with autologous arteriovenous fistula(P<0.01).There was no significant difference in resistance index between patients with autologous arteriovenous fistula(P〉0.05).Conclusions Color Doppler ultrasound can accurately assess the patency of arteriovenous fistula in upper limbs of hemodialysis patients,which is worthy of clinical application.