彩色多普勒超声在血液透析动静脉造瘘术前血管评估的应用

Application of Color Doppler Ultrasound in Vascular Evaluation before Hemodialysis Arteriovenous Fistula

目的:探析彩色多普勒超声在血液透析动静脉造瘘术前血管评估的应用价值,为后续临床检测奠定基础。方法:以本院2019年5月—2021年5月收治的80例需进行血液透析动静脉造瘘术患者为例,对其进行彩色多普勒超声并分析其影像,判定筛选适合吻合造瘘的血管。结果:共有12例患者放弃了造瘘,其中3例由于头静脉内径过细(小于1.2mm),2例由于头静脉位置太深,3例桡动脉壁发生钙化,3例腋动脉显著狭窄,1例锁骨下动脉狭窄。8例失败,其中5例由于血管血流量不足,3例发生血栓。最终参与研究的患者中造瘘成功患者60例,成功率为75.00%;比较造瘘成功与失败患者的动静脉内径、血流量及流速发现成功组患者结果均显著高于对照组(P<0.05),具有统计学意义。结论:彩色多普勒超声应用于血液透析动静脉造瘘术前血管评估,可以有效分析患者的血管情况,筛除不适合造瘘术的患者,减少不必要的手术浪费,提升治疗效果。

Objective:To explore the application value of color Doppler ultrasound in vascular evaluation before hemodialysis arteriovenous fistula,and lay a foundation for subsequent clinical detection.Methods:A total of 80 hemodialysis arteriovenous fistula patients admitted to our hospital from May 2019 to May 2021 were selected as examples.Color Doppler ultrasound was performed on them and their images were analyzed to determine and screen suitable vessels for anastomostomy.Results:A total of 12 patients gave up stomy,including 3 due to narrow cephalic vein diameter(less than 1.2mm),2 due to deep cephalic vein location,3 due to calcification of radial artery wall,3 due to significant axillary artery stenosis,and 1 due to subclavian artery stenosis.Eight cases failed,of which five were due to insufficient blood flow to the vessels and three had thrombosis.Among the patients who finally participated in the study,there were 60 patients with successful fistula,with a success rate of 75.00%;The results of arteriovenous diameter,blood flow and flow rate in successful and failed patients were significantly higher than those in control group(P<0.05),which was statistically significant.Conclusions:The application of color Doppler ultrasound in preoperative vascular evaluation of hemodialysis arteriovenous fistula can effectively analyze the vascular condition of patients,screen out patients who are not suitable for fistula,reduce unnecessary surgical waste,and improve the therapeutic effect.