高频彩色多普勒超声评估前臂自体动静脉内瘘功能、血流动力学及狭窄的价值

The Value of High Frequency Color Doppler Ultrasonography in Evaluating Function, Hemodynamics and Stenosis of Forearm Autologous Arterio-venous Fistula

目的:探讨高频彩色多普勒超声(HF-CDU)评估前臂自体动静脉内瘘(AVF)功能、血流动力学及狭窄的价值。方法:连续纳入2018年1月~2020年8月于我院行前臂自体AVF的54例维持性血液透析(MHD)患者为研究对象。对患者进行HF-CDU检查,记录术前及术后2个月的桡动脉管径(RAD)、头静脉管径(CVD)、肱动脉管径(BAD)、桡动脉血流量(RVF)、头静脉血流量(CVF)及肱动脉血流量(BVF),记录术后2个月的AVF中头静脉、桡动脉及肱动脉的管径、血流速度(PSV)、阻力指数(RI)、血流量(BF)及AVF的狭窄情况。结果:术后2个月患者的RAD、CVD、BAD、RVF、CVF及BVF均明显大于术前(P<0.05)。术后2个月,头静脉的管径最大、桡动脉的管径最小,肱动脉的PSV最大、头静脉PSV最小,肱动脉的RI最大、头静脉的RI最小,肱动脉的BF最大、桡动脉的BF最小,差异均具有统计学意义(P<0.05)。术后2个月HF-CDU检查诊断出自体AVF狭窄6例(11.11%)。结论:HF-CDU能够对前臂自体AVF的功能、血流动力学及狭窄情况进行有效评估。

Objective:To discuss the value of high frequency color Doppler ultrasonography(HF-CDU) in evaluating function, hemodynamics and stenosis of forearm autologous arterio-venous fistula(AVF).Methods:54 patients with maintenance hemodialysis(MHD) who underwent forearm autologous AVF which was included as study subjects in our hospital from January 2018 to August 2020. The patients were examined by HF-CDU. The radial artery diameter(RAD), cephalic vein diameter(CVD), brachial artery diameter(BAD), radial venous flow(RVF), cephalic venous flow(CVF) and brachial venous flow(BVF) was recorded before operation and 2 months after operation. The diameters, peak systolic velocity(PSV), resistance index(RI), blood flow(BF) of cephalic vein, radial artery and brachial artery in AVF and stenosis of AVF was recorded 2 months after operation.Results:2 months after operation, the RAD, CVD,BAD, RVF, CVF and BVF of the patients were significantly higher than those before operation(P<0.05). 2 months after operation, the cephalic vein had the largest diameter, the radial artery had the smallest diameter, the brachial artery had the largest PSV and the cephalic vein had the smallest PSV, the brachial artery had the largest RI and the cephalic vein had the smallest RI, the brachial artery had the largest BF and the radial artery had the smallest BF, and the differences were statistically significant(P<0.05). 2 months after operation, there were 32 cases(59.25%) with stenosis of autologous AVF which was diagnosed by HF-CDU.Conclusion:HF-CDU could effectively evaluate the function, hemodynamics and stenosis of forearm autologous AVF.