彩色多普勒超声联合二维灰阶血流(B-Flow)成像技术在血液透析患者动静脉瘘术后监测中的应用价值

Application value of color Doppler ultrasound with B-Flow imaging technique in postoperative monitoring for arteriovenous fistula of hemodialysis patients

目的:研究彩色多普勒超声(CDU)联合二维灰阶血流(B-Flow)成像技术在血液透析患者动静脉瘘术后监测中的应用价值。方法:选择医院收治的60例需进行动静脉瘘手术的血液透析尿毒症患者,采用CDU联合B-Flow技术监测动静脉瘘手术前后患者的心功能左心室射血分数(LVEF)、右室内径(RVID)、左心房前后径(LAID)和左心室舒张末期容积(LVEDV)指标,以及血流动力学桡动脉管径(RAD)、头静脉管径(CVD)、桡动脉血流量(RVF)、头静脉血流量(CVF)、收缩期峰值流速(PSV)、血流量(BF)和阻力指数(RI)等指标,监测患者并发症的发生情况。结果:构建动静脉瘘后,患者心功能指标LVEF明显下降,RVID、LAID明显提高,LVEDV明显增大,与动静脉瘘术前比较差异有统计学意义(t=8.626,t=8.261,t=9.455,t=7.844;P<0.05);血流动力学指标RAD、CVD、RVF、CVF、PSV和BF均明显提高,RI明显降低,与动静脉瘘术前比较差异有统计学意义(t=17.872,t=33.889,t=19.333,t=2.898,t=23.845,t=17.122,t=23.901;P<0.05);随动静脉瘘构建时间的延长,各项指标变化更明显。构建动静脉瘘后37例(占61.66%)患者无并发症发生,23例(占38.33%)出现一种或以上并发症。结论:CDU联合B-Flow技术对血透患者动静脉瘘术后监测中,可更清晰准确地监测手术是否成功、并对并发症进行早期监测。

Objective:To study the application value of color Doppler ultrasound(CDU)that combined with B-Flow imaging technique in postoperative monitoring for arteriovenous fistula of hemodialysis patients.Methods:60 patients with uremia who were treated by hemodialysis and underwent the surgery of arteriovenous fistula in our hospital were selected.CDU combined with B-Flow was used to monitor cardiac function including left ventricular ejection fraction(LVEF),right ventricular internal diameter(RVID),left atrium inner diameter(LAID),left ventricular end diastolic volume(LVEDV)and hemodynamic indexes including radial artery diameter(RAD),cephalic vein diameter(CVD),radial artery volume flow(RVF),cephalic vein volume flow(CVF),peak systolic velocity(PSV),blood flow(BF),and resistance index(RI)before and after the surgery of arteriovenous fistula of patients,and to monitor the occurrence of complications of patients.Results:Compared with pre the surgery of arteriovenous fistula of patients,LVEF of cardiac functional indicators of patients significantly decreased(t=8.626,P<0.05),and RVID and LAID of them significantly increased(t=8.261,t=9.455,P<0.05),and LVEDV of them significantly increased(t=7.844,P<0.05)post the construction of arteriovenous fistula of patients.And compared with that,the increases of RAD,CVD,RVF,CVF,PSV and BF post the construction of arteriovenous fistula of patients were significant(t=17.872,t=33.889,t=19.333,t=2.898,t=23.845,t=17.122,t=23.901,P<0.05),respectively.With the extension of construction time of arteriovenous fistula,the changes of each indicator were more significant.After the arteriovenous fistulas were constructed,there were no complications in 37 patients(61.66%),and 23 patients had one or more complications.Conclusion:In the postoperative monitoring of arteriovenous fistula for patients who are treated by hemodialysis and undergo CDU combined with B-Flow technique,this technique can more clearly and accurately monitor whether the operation is successful,and it can implement monitor for the complications of them in the early stage.