文章摘要
赵 亮,蔡 琴,王栋颖,尹文雁,张 婧.彩色多普勒超声对尿毒症血液透析患者动静脉内瘘的术前及术后监测效果分析[J].,2020,(12):2309-2312
彩色多普勒超声对尿毒症血液透析患者动静脉内瘘的术前及术后监测效果分析
Analysis of Preoperative and Postoperative Monitoring Effects of Color Doppler Ultrasound on Arteriovenous Fistula in Uremia Hemodialysis Patients
投稿时间:2019-12-30  修订日期:2020-01-23
DOI:10.13241/j.cnki.pmb.2020.12.023
中文关键词: 彩色多普勒超声  尿毒症  血液透析  动静脉内瘘  并发症
英文关键词: Color Doppler ultrasound  Uremia  Hemodialysis  Arteriovenous fistula  Complications
基金项目:国家卫生计生委医药卫生科技发展项目(W2015CAE173)
作者单位E-mail
赵 亮 南京中医药大学第二附属医院(江苏省第二中医院)肾内科 江苏 南京 210017 zhao1987liang09@163.com 
蔡 琴 南京中医药大学第二附属医院(江苏省第二中医院)肾内科 江苏 南京 210017  
王栋颖 南京中医药大学第二附属医院(江苏省第二中医院)肾内科 江苏 南京 210017  
尹文雁 南京中医药大学第二附属医院(江苏省第二中医院)肾内科 江苏 南京 210017  
张 婧 南京医科大学附属儿童医院超声诊断科 江苏 南京 210008  
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中文摘要:
      摘要 目的:探讨与分析彩色多普勒超声对尿毒症血液透析患者动静脉内瘘的术前及术后监测效果。方法:选择2017年2月至2019年5月在本院诊治的尿毒症血液透析并行自体动静脉内瘘的患者90例,在术前1-3 d与术后3个月进行超声监测,记录超声特征。记录患者术后内瘘失功、并发症发生情况并进行相关性分析。结果:所有患者都顺利完成自体动静脉内瘘;术后3个月患者自体动静脉内瘘在超声上表现为"u"或"v"形管状结构,表现为高速低阻动静脉瘘血流频谱,瘘口处彩色血流均显示为五彩镶嵌紊乱血流。术后3个月患者的头静脉与桡动脉内径、血流量都高于术前(P<0.05)。90例患者术后3个月发生血栓形成2例、狭窄1例和静脉瘤样扩张4例,并发症发生率为7.8 %。同时发生8例动静脉内瘘失功,发生率为8.9 %;Pearson相关分析法显示术后动静脉内瘘失功、并发症发生情况与头静脉、桡动脉内径与血流量存在显著相关性(P<0.05)。结论:彩色多普勒超声应用于尿毒症血液透析患者及动静脉内瘘患者可监测内瘘血流动力学、血管形态学变化,能够客观评价内瘘失功与并发症发生情况。
英文摘要:
      ABSTRACT Objective: To investigate and analysis the effect of preoperative and postoperative monitoring of color Doppler ultrasound on arteriovenous fistula in uremia hemodialysis patients. Methods: 90 caees of patients with uremia hemodialysis and autologous arteriovenous fistula selected for treatment in our hospital from February 2017 to May 2019 were selected. Ultrasound monitoring were performed preoperative 1-3 d and postoperative 3 months, recorded the ultrasound feature. The postoperative internal fistula failure and complications were recorded and the correlation analysis were performed. Results: All patients were successfully completed autologous arteriovenous fistula; At the 3 months after operation, the autologous arteriovenous fistula were showed "u"and "v" tubular structure on ultrasound, and were showed high-speed and low-blocking arteriovenous fistula blood flow. In the frequency spectrum, the colored blood flow at the fistula is shown as multicolored mosaic disordered blood flow. The internal diameter and blood flow of the cephalic vein and radial artery were higher than those before surgery at 3 months after operation (P<0.05). There were 3 patients were thrombosis at the 3 months after operation in the 90 patients, and were 1 patient of stenosis, and 4 patients of venous tumor-like dilation that the complication rates were 7.8 %. And there were 8 cases of arteriovenous fistula failure at the same time, the incidence rates were 8.9 %. Pearson correlation analysis showed that arteriovenous fistula failure and complications after operation were significantly correlated with the internal diameter of the cephalic vein, radial artery, and blood flow (P<0.05). Conclusion: Color Doppler ultrasound can be used to monitor the hemodynamics and vascular morphology of internal fistula in patients with arteriovenous fistula in patients with uremia and hemodialysis. It can objectively evaluate the failure and complications of internal fistula.
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