彩色多普勒超声监测在终末期肾病患者动静脉瘘成形术中的临床应用  

Clinical application of color Doppler ultrasonography in monitoring angioplasty for arteriovenous fistula in patients with end-stage renal disease

作　　者：郭卫东[1] 张晓玲[2] 李文洪 曹亚坤[1] 焦雷红[1] 王运涛 GUO Wei-dong;ZHANG Xiao-ling;LI Wen-hong;CAO Ya-kun;JIAO Lei-hong;WANG Yun-tao(Department of Ultrasound Medicine, the Third Hospital of Shijiazhuang City, Hebei Province,Shijiazhuang 050017,China;Department of Imaging, Cangzhou Medical College, Hebei Province, Cangzhou 061001, China)

机构地区：[1]河北省石家庄市第三医院超声医学科,河北石家庄050017 [2]沧州医学高等专科学校影像系,河北沧州061001

出　　处：《河北医科大学学报》2021年第2期205-208,共4页Journal of Hebei Medical University

基　　金：石家庄市科学技术研究与发展指导计划(131461393)。

摘　　要：目的应用彩色多普勒超声检测终末期肾病患者桡动脉-头静脉形成术端侧吻合术与端端吻合术2种手术方式并发症的发生率,评估不同术式的差异优劣。方法选择成功行2种手术方式治疗终末期肾脏病患者各60例,应用彩色多普勒超声检测血管腔内血栓形成、瘘口处狭窄、动静脉瘤样扩张3种较高发生并发症的发生率,将2组数据进行统计学分析。结果彩色多普勒超声能准确监测动静脉瘘术后并发症的发生。端端吻合组血栓形成、瘘口狭窄发生率高于端侧吻合组,差异有统计学意义(P<0.05),而2组瘤样扩张的发生率差异无统计学意义(P>0.05)。结论应用彩色多普勒超声能够准确检查2种手术方式的术后常见并发症,临床中可作为经济有效且准确的首选检查手段;在常用的2种手术方式中,采用动静脉端侧吻合手术方式的病例并发症发生较少且较轻,建议在临床手术适应证范围内,作为首选方案。Objective To detect the incidence of complications of the two surgical methods-the end-to-side and end-to-end radial artery-cephalic vein anastomosis in patients with end-stage renal disease(ESRD)by color Doppler ultrasonography(CDUS),and to evaluate the advantages and disadvantages of two surgical methods.Methods We selected 60 patients with ESRD that had been treated successfully by the two surgical methods respectively.CDUS was used to detect the three kinds of complications that were higher in incidence in the two groups:endovascular thrombosis,fistula stenosis and aneurysmal dilation of the involved artery and vein.Two sets of data were analyzed statistically.Results CDUS could accurately monitor the occurrence of postoperative complications of arteriovenous fistula,The incidence of endovascular thrombosis and fistula stenosis in end-to-end anastomosis group was higher than that in end-to-side anastomosis group(P<0.05),but there was no significant difference in the incidence of aneurysmal dilation in two groups(P>0.05).Conclusion CDUS can be used to detect the common postoperative complications of the two surgical methods accurately,and it can be used as the preferred choice for its cost-effectiveness and accuracy in clinical practice.Among the two commonly used surgical methods,the end-to-side radial artery-cephalic vein anastomosis has fewer complications and milder symptoms,and is therefore recommended as the first choice on the basis of surgical indications.

关 键 词：超声检查 多普勒 彩色 动静脉瘘 血栓形成 

分 类 号：R445.1[医药卫生—影像医学与核医学]