彩超联合血管CT成像在终末期肾脏病患者动静脉瘘成形术中的应用  

Application of color doppler ultrasound combined with vascular CT imaging in arteriovenous fistuloplasty of end-stage renal disease

作　　者：张晓玲[1] 宣之东[2] 郭卫东[3] 王娇[1] ZHANG Xiaoling;XUAN Zhidong;GUO Weidong;WANG Jiao(Cangzhou Medical College,Cangzhou 061001,China)

机构地区：[1]沧州医学高等专科学校,河北沧州061001 [2]沧州市中心医院,河北沧州061001 [3]石家庄市第三医院,石家庄050011

出　　处：《实用医学杂志》2018年第21期3628-3632,共5页The Journal of Practical Medicine

基　　金：河北省石家庄市科学技术研究与发展指导计划课题(编号:131461393)

摘　　要：目的探讨彩超联合血管CT成像在终末期肾脏病患者动静脉瘘成形术中的应用价值。方法选取2015年6月至2017年6月于石家庄市第三医院收治的201例终末期肾脏病患者作为研究对象,均行动静脉瘘成形术,按照随机数字表法划分为3组,各组67例。彩超组在术前术后仅行彩超检查,血管CT成像组仅行血管CT成像检查,联合组行彩超与血管CT成像检查,观察各组患者术后内瘘成功率与通畅率、血流速度与血流量及并发症发生率。结果彩超与血管CT成像联合应用内瘘成功率与通畅率显著高于单一指标检查(P <0.05);各组术后血流速度与血流量均显著高于术前,且彩超与血管CT成像联合血流速度与血流量显著高于单一指标检查(P <0.05);彩超与血管CT成像联合应用并发症发生率显著低于单一指标检查(P <0.05);联合检查组中有26例患者表现正常,其中9例为吻合口近端静脉狭窄,11例为单纯流出静脉狭窄,6例为单纯流入动脉狭窄,5例为吻合口狭窄,8例为流入动脉、吻合口、流出静脉狭窄,2例为窃血。结论在终末期肾脏病患者动静脉瘘成形术中联合应用彩超与血管CT成像可促使内瘘成熟,逐步恢复血管功能,降低并发症发生率,对动静脉瘘成形术提供准确信息,,可在临床中广泛应用以提高治疗效果。Objective To investigate the value of color Doppler ultrasound combined with vascular CT imaging in arteriovenous fistuloplasty of end-stage renal disease.Methods Two hundred and one patients with endstage renal disease in our hospital from June 2015 to June 2017 were divided into three groups according to random number table method,with 67 cases in each group.Color Doppler ultrasonography was performed before and after operation in the color Doppler ultrasound group,vascular CT imaging was performed in the vascular CT imaging group,and color Doppler ultrasonography combined with vascular CT imaging were performed in the combined group.Results The success rate and patency rate of the combination of color Doppler ultrasonography and CT angiography were significantly higher than those in the other two groups(P<0.05,respectively).The blood flow velocity and blood flow were significantly higher in each group after operation than those before operation,mean-while,they were significantly higher in the combination group than those the other two groups with one single index examination(P<0.05,respectively).The incidence of complications in the combination group than those the other two groups with one single index examination(P<0.05,respectively).Twenty-six patients in the combination group showed normal manifestations,including 9 cases of proximal anastomotic stenosis,11 cases of simple effluent vein stenosis,6 cases of simple inflow artery stenosis,5 cases of anastomotic stenosis,8 cases of inflow artery,anastomotic stomosis and outflow vein stenosis,and 2 cases of blood theft.Conclusion The combination of color Doppler ultrasonography and CT angiography can promote the maturation of arteriovenous fistula in patients with end-stage renal disease,with gradual restoration of vascular function,reducing the incidence of complications,providing accurate information for arteriovenous fistula plasty,and can be widely used in clinic to improve the treatment effect.

关 键 词：彩超 血管CT成像 终末期肾脏病 动静脉瘘成形术 

分 类 号：R445.1[医药卫生—影像医学与核医学] R816.7[医药卫生—诊断学] R692.5[医药卫生—临床医学]