多普勒超声在自体动静脉内瘘建立和维护中的应用研究进展

Application of doppler ultrasound in establishment and maintenance of autogenous arteriovenous fistula

自体动静脉内瘘是尿毒症患者血液透析时首选的血管通路,在临床应用过程中容易出现各种并发症,其包括血栓形成、狭窄、头静脉段瘤样扩张、穿刺点血管壁增厚、血肿、假性动脉瘤形成等。超声在术前可以用于评估血管,预测内瘘的成熟,监测手术前血管内径和血流情况。在手术中可进行血管探查,并辅助引导定位。在手术后进行血管评估、监测及随访,并对下一步治疗方案做出及时调整。除此以外,超声还可以辅助内瘘成熟并对各种并发症进行治疗。本文就多普勒超声在自体动静脉内瘘建立和维护中的应用进展进行综述。

Autologous arteriovenous catheter is the preferred vascular access for uremic patients during hemodialysis.But It can easily cause all kinds of complications in the process of clinical application.including thrombosis,stenosis,tumorlike dilatation of cephalic vein segment,thickening of vascular wall at puncture point,hematomas,formation of pseudoa⁃neurysm,etc.Ultrasound can be used to evaluate blood vessels before operation,predict the maturity of internal fistula,and monitor the diameter and blood flow of blood vessels before operation.Vascular exploration can be carried out in the operation,and guidance and localization can be assisted.Vascular assessment,monitoring and follow-up after operation,and make timely adjustments to the following treatment plan.In addition,ultrasound can also assist in the maturation of internal fistula and the treatment of various complications.This article reviews the application of doppler ultrasound in the establishment and maintenance of autogenous arteriovenous fistula.