彩色多普勒超声监测自体动静脉内瘘并发症致低血流量的应用价值  

The Application of Color Doppler Ultrasound Monitoring the Complications of Low Volume of Blood Flow Caused by Native Arteriovenous Fistula

作　　者：傅建群[1] 江峡[1] 

机构地区：[1]广东省佛山市南海区第二人民医院,广东佛山528251

出　　处：《黑龙江医学》2012年第7期481-483,共3页Heilongjiang Medical Journal

摘　　要：目的探讨彩色多普勒超声监测自体动静脉内瘘(native arteriovenous fistula,NAVF)并发症致内瘘低血流量的使用价值。方法回顾分析我院肾内科2006-06～2009-12间,AVF维持性血液透析患者154例病历资料,使用彩色多普勒超声检查AVF狭窄、血栓等并发症,以低血流量为终点事件,分析AVF并发症对低血流量的影响。结果 154例中,21例出现低血流量,发生率13.64%[1]。21例为低血流量组,133例为正常组。分析两组资料,内瘘血管狭窄、血栓、瘘口血流量及深静脉近心端血栓,差异有统计学意义(P<0.05)。内瘘感染、静脉瘘样扩张、假性动脉瘤、静脉分支、桡动脉、吻合口、头静脉内径差异无统计学意义。结论 AVF血管狭窄和血栓是影响瘘口低血流量的主要因素;超声所测头静脉内瘘血流量与透析时血流量存在一定误差,通过彩色多普勒二维图像、彩色血流显像、频谱综合分析AVF血管情况,能及时发现并发症所致低血流量因素,为临床早期干预提供参考意见。Objective To explore the application of color doppler ultrasound monitoring the complications of low volume of blood flow caused by native arteriovenous fistula（NAVF）. Methods 154 maintenance hemodialysis cases of NAVF were inspected with color Doppler ultrasonography, to observe the complications, such as NAVF stenochoria and thrombus , and low volume of blood flow was chosen as terminal event to analysis the influence of NAVF complications in our hospital from the June of 2006 to December of 2009. Resul~ low volume of blood flow occurred on 21 of 154cases （ 13.64% ）. The data were analyzed between low volume of blood flow group （21 cases） and normal group （133 cases ）, and there are significant differences in internal fistula angiostegnosis, thrombus, the volume of blood flow of orificium fistulae, and thrombus of proximal part venae profundae （P 〈 0. 05 ）, however; there is not significant difference in internal fistula infection, vein fistula type distension, pseudoaneurysm, venous tributary, arteria radialis, stoma, internal diameter of cephalic vein（ P 〉 0. 05 ）. Conclusion Angiostegnosis and thrombus of NAVF are major factors to affect the low volume of blood flow of orificium fistu- lae. There is a certain mismatch between hyperacoustic measured volume of blood flow of the cephalic vein internal fistula and the volume of blood flow of dislysis. By the application of color Doppler 2D topolgraphy, color blood flow display and spectra aggregately in the blood vessel information of AVF, we can promptly find the factors to cause the low volume of blood flow with complications, and provide the reference for clinical early intervention.

关 键 词：维持性血液透析 自体动静脉内瘘 内瘘并发症 低血流量 彩色多普勒超声 

分 类 号：R445.1[医药卫生—影像医学与核医学]