血管内超声在透析血管通路中的应用

Application of intravascular ultrasound in vascular access for dialysis

透析血管通路对于透析患者至关重要,其相关并发症的发病率相对较高。目前,常采用数字减影血管造影(DSA)对透析血管通路进行检查、治疗及干预。DSA检查所呈现的图像是传统的二维图像,对三维血管结构的暴露有限。血管内超声(IVUS)检查可弥补DSA在透析血管通路检查方面的不足,不仅能够精确检查透析血管通路相关并发症的发生情况,还能够提高术者的操作准确性,减少术者及患者的射线暴露。对于对造影剂过敏的透析患者,也可单独使用IVUS检查进行干预。另外,IVUS检查有助于对透析血管通路狭窄机制的研究。通过IVUS辅助治疗可进一步延长透析血管通路的使用寿命,从而提高透析患者的透析质量。

Dialysis vascular access is critical for dialysis patients,and the incidence of related complications is relatively high.At present,digital subtraction angiography(DSA)is often used for examination,treatment and intervention in dialysis vascular access.The images presented by DSA are traditionally two-dimensional images with limited exposure to three-dimensional vascular structures.Intravascular ultrasound(IVUS)examination can make up the limitation of DSA in dialysis vascular access examination.IVUS can accurately detect the occurrence of complications related to dialysis vascular access,improve the operation accuracy of operators,and reduce the radiation exposure of operators and patients.IVUS alone can also be used for intervention in dialysis patients who are allergic to contrast agent.In addition,IVUS also contributes to the study of the mechanism of dialysis vascular access narrowing.Adjuvant IVUS therapy can further extend the life of the dialysis access,thereby improving the quality of dialysis.