动静脉内瘘成形术对终末期肾病患者心脏结构及功能影响的超声评价  

Efficacy Evaluation of Arteriovenous Fistula Plasty in Cardiac Structure and Function in Patients with End-Stage Renal Disease by Ultrasound

作　　者：马黎丽[1] 富琳岩[1] 沈英[1] 

机构地区：[1]绍兴市中医院肾内科,312000

出　　处：《医学研究杂志》2017年第2期155-157,共3页Journal of Medical Research

摘　　要：目的探讨动静脉内瘘(AVF)成形术对终末期肾病(ESRD)患者心脏结构及功能影响,及基于心脏超声的效果评价。方法以笔者医院2012年1月~2015年3月拟行AVF术的62例ESRD患者为研究对象,根据吻合口直径分为A、B两组。所有患者均在术前、术后1年进行心脏彩色超声检查,测量左心房内径(LAD)、左心室舒张末期容积(LVEDV)、射血分数(EF)、短轴缩短率(FS)等指标。测量AVF吻合口直径、血流量、体重增长率。比较两组心脏结构和功能的变化,及其与血流量、体重的相关性。结果 62例ESRD患者均顺利完成AVF术,未见任何相关并发症,手术成功率、1期内瘘通畅率均为100%。术后1年复查,两组LAD、LVEDV明显增大,B组EF、FS明显降低,A组EF、FS高于B组(P<0.05)。内瘘血流量与LAD呈正相关,与EF、FS呈负相关(P<0.05)。体重增长率与LAD、LVEDV呈正相关,与EF、FS呈负相关(P<0.05)。结论心脏超声是评估AVF的重要手段,积极监测内瘘血流量、控制体重有助于延缓或逆转ESRD患者AVF术后心脏结构及功能变化。Objective To explore influence of arteriovenous fistula（AVF） plasty in cardiac structure and function in patients with end-stage renal disease（ESRD）, and to evaluate the effect byultrasound. Methods Echocardiography was performed for all the patients before and 1 year after operation. Left atrium diameter（LAD）, left ventricular end-diastolic volume（LVEDV）, ejection fraction（EF）, fractional shortening（FS） were detected, and diameter of AVF anastomosis, blood flow, growth rate of weight were measured. The change of cardiac structure and function between two groups, and its correlation with blood flow, and weight were measared. Results 62 cases of ESRD patients underwent the AVF operation successfully, no related complications were found, surgical success rate, patency rate of one-stage fistula was 100%. After 1 year review, LAD, LVEDV in both groups increased obviously.EF, FS, EF, FS in Group A was higher than that in Group B（P〈0.05）. Blood flow of fistula was positively correlated with the LAD, and negatively correlated with EF, FS（P〈0.05）. Body weight growth rate was positively correlated with the LAD, LVEDV, and negatively correlated with EF, FS（P〈0.05）. Conclusion Echocardiogram is an important method of evaluating AVF, and active surveillance blood flow of fistula, weight control can contribute to slow down or even reverse cardiac structure and function after AVF in patients with ESRD.

关 键 词：动静脉内瘘成形术 终末期肾病 心脏结构 心功能 超声评价 

分 类 号：R318.11[医药卫生—生物医学工程]