探讨彩色多普勒超声诊断血液透析动静脉内瘘血流量减低的价值

To Investigate the Value of Color Doppler Ultrasound in Diminishing Blood Flow of Hemodialysis Arteriovenous Fistula

目的探讨彩色多普勒超声诊断血液透析动静脉内瘘血流量减低的价值。方法回顾性分析2016年12月至2018年12月江苏省泰兴市人民医院行血液透析治疗的56例动静脉内瘘患者,所有患者均行彩色多普勒超声诊断,其中22例出现低血流量为低血流量组,其余34例为正常组。观察并分析2组内瘘并发症情况及桡动脉内径、吻合口直径、头静脉内径、内瘘血流量差异。结果低血流量组狭窄及血栓发生率高于正常组,且差异有统计学意义(P<0.05);2组内瘘感染、假性动脉瘤、静脉瘤样扩张、静脉分流发生率差异无统计学意义(P>0.05);低血流量组内瘘血流量低于正常组,桡动脉内径、吻合口直径、头静脉内径小于正常组,且差异有统计学意义(P<0.05)。结论彩色多普勒超声可有效诊断血液透析动静脉内瘘患者的血流量减低情况及不良反应,为患者的治疗提供可靠依据,具有较高的临床诊断价值。

Objective To explore the value of color doppler ultrasound in diagnosing blood flow reduction in hemodialysis arteriovenous fistula.Methods Retrospective analysis of 56 patients with arteriovenous fistula treated with hemodialysis in Taixing People's Hospital of Jiangsu Province from December 2016 to December 2018,All patients were diagnosed by color doppler ultrasound,among them,22 patients with low blood flow were in the low blood flow group,and the remaining 34 patients were in the normal group.The complications of internal fistula and the difference of internal diameter of radial artery,diameter of anastomosis,internal diameter of cephalic vein,and blood flow of internal fistula in the two groups were observed and analyzed.Results The incidence of stenosis and thrombosis in the low blood flow group were higher than those in the normal group(P<0.05).There was no significant difference in the incidence of fistula infection,pseudoaneurysm,venous tumor-like dilatation,and venous shunt in the two groups(P>0.05).The blood flow of fistula in the low blood flow group was lower than that in the normal group,and the inner diameter of the radial artery,the diameter of the anastomosis,and the inner diameter of the cephalic vein were smaller than the normal group(P<0.05)Conclusion Color Doppler ultrasound can effectively diagnose the decrease of blood flow and adverse reactions in patients with hemodialysis arteriovenous fistula,provide a reliable basis for patient treatment,and have high clinical diagnostic value.