慢性血液透析患者鼻烟窝动静脉内瘘的彩超评价  

Color Doppler Ultrasonographic Evaluation of Snuffbox Arteriovenous Fistula in Patients with Chronic Hemodialysis

作　　者：陈小武[1] 汪奠亚 张慧[1] 

机构地区：[1]安徽省安庆市石化医院超声科,246001

出　　处：《中华全科医学》2011年第2期300-301,F0003,共3页Chinese Journal of General Practice

摘　　要：目的通过对慢性血液透析患者鼻烟窝动静脉内瘘的彩超监测,并与常规前臂动静脉内瘘比较,以评价鼻烟窝动静脉内瘘的应用价值。方法 51例慢性血液透析患者按内瘘术式不同分为二组,其中鼻烟窝动静脉内瘘组30例、前臂动静脉内瘘组21例,应用彩色多普勒超声监测比较二者手术1年后通畅率、吻合口内径、吻合口平均血流量及并发症发生率。结果鼻烟窝动静脉内瘘组与前臂动静脉内瘘组手术1年后通畅率分别为90.0%(27/30)和90.5%(19/21);吻合口内径分别为(3.10±0.11)mm和(3.40±0.12)mm;吻合口平均血流量分别为(368.4±6.2)ml/m in和(381.2±6.0)ml/m in;并发症发生率分别为10.0%(3/30)和23.8%(5/21)。二者比较在手术1年后通畅率、吻合口内径、吻合口平均血流量及并发症发生率上差异无统计学意义(P>0.05)。结论鼻烟窝动静脉内瘘与前臂动静脉内瘘比较,在手术1年后通畅率、吻合口内径、吻合口平均血流量及并发症发生率上无明显差异,可做为慢性血液透析患者首选的内瘘术式之一。Objective To study the value of the color Doppler ultrasound in monitoring the snuffbox arteriovenous fistula in patients with chronie hemodialysis. Methods Fifty one chronic hemodialysis patients were divided into two groups,30 patients at the snuffbox arteriovenous fistula and the other 21 ones at the forearm arteriovenous fistula. The free circulation rate ,diameter of anastomoses, volume of blood flow and complication rate of anastomoses were compared among them one year after the surgical operation. Results In the Snuffbox group, the free circulation rate was 90.0% （27/30） , diameter of anastomoses was （ 3. 10 ± 0.11 ）ram,volume of blood flow was（368.4 ±6.2） ml/min and complications rate was 10.0% （3/30） ;in the forearm group,free circulation rate was 90.5 % （ 19/21 ） , diameter of anastomoses was （ 3.40± 0.12 ）mm ;, volume of blood flow was （ 381.2 ± 6.0） ml/min and eomplieation rate was 23.8% （5/21）. There was no significant differences between the two groups on the free eireulation rate, diameter of anastomoses, volume of blood flow and eomplieation rate （ P 〉 0.05 ）. Conclusion Compared with the forearm arteriovenous fistula, the snuffbox arteriovenous fistula has not statistical signifieanee on the free circulation rate, diameter of anastomoses, volume of blood flow and complication rate. It is one of the first chosen of surgery for internal fistula in patients with ehronic hemodialysis.

关 键 词：彩色多普勒超声 鼻烟窝动静脉内瘘 血液透析 

分 类 号：R459.52[医药卫生—治疗学] R445.14[医药卫生—临床医学]