探讨高频超声诊断前臂动静脉内瘘并发症的价值  

Value Exploration of High-frequency Ultrasound in Diagnose of Complications of Forearm Arteriovenous Fistula

作　　者：蔡丹琴 谢伟超[1] 徐林凤[1] 苏丹萍[1] CAI Danqin;XIE Weichao;XU Linfeng;SU Danping(Chaozhou City Central Hospital,Chaozhou,Guangdong 521000)

机构地区：[1]潮州市中心医院,广东潮州521000

出　　处：《智慧健康》2023年第17期13-18,共6页Smart Healthcare

基　　金：潮州市卫生健康局科研项目《基于高频超声诊断自体动静脉内痿并发症价值的研究》(项目编号:潮卫科研2022057号)。

摘　　要：目的 探讨高频彩色多普勒超声对动静脉内瘘并发症的诊断价值。方法 选取2018年5月-2023年3月在潮州市中心医院血透病情稳定的动静脉内瘘患者79例为研究对象,评估高频超声对其动静脉内瘘并发症的监测结果。结果 15例(18.99%)前臂动静脉内瘘血流通畅,透析过程中相关指标无异常。64例(81.01%)前臂动静脉瘘出现并发症,其中15例(23.44%)同时出现多种并发症。出现血栓形成35例(48.61%),其中血栓形成病例中单纯头静脉血栓25例,头静脉合并肘正中静脉血栓5例,人工血管血栓4例,贵要静脉血栓1例;出现血管狭窄23例(29.48%),其中血管狭窄的病例中吻合口狭窄13例,头静脉狭窄8例,人工血管狭窄2例;出现头静脉瘤样扩张10例(12.82%);出现血肿7例(11.53%);出现高流量内瘘5例(6.32%)。结论 高频彩色多普勒超声可监测稳定血透患者动静脉内瘘血流量,发现内瘘常见的并发症,找出责任血管狭窄、闭塞问题,及早干预,为临床后续的进一步治疗提供有效指导。Objective To explore diagnostic value of high-frequency color Doppler ultrasound for complications of arteriovenous fistula.Methods The paper chose 79 cases arteriovenous fistula patients with stable hemodialysis conditions in Chaozhou City Central Hospital from May 2018 to March 2023 as research objects,monitoring results of high-frequency ultrasound on complications of arteriovenous fistula were evaluated.Results Blood flow of 15 cases(18.99%)of forearm arteriovenous fistula was unobstructed,there were no abnormalities in relevant indicators during dialysis.64 cases(81.01%)had complications of forearm arteriovenous fistula,of which 15 cases(23.44%)had multiple complications simultaneously.35 cases(48.61%)had thrombosis,including 25 cases of simple cephalic vein thrombosis,5 cases of cephalic vein thrombosis combined with median elbow vein thrombosis,4 cases of artificial vessel thrombosis and 1 case of basilic vein thrombosis.There were 23 cases of stenosis(29.48%),including 13 cases of anastomotic stenosis,8 cases of cephalic vein stenosis and 2 cases of artificial stenosis stenosis in stenosis cases.10 cases(12.82%)showed tumor like dilation of cephalic vein.7 cases(11.53%)had hematoma,5 cases(6.32%)had high flow internal fistula.Conclusion High frequency color Doppler ultrasound can monitor blood flow of arteriovenous internal fistula patients with stable hemodialysis,find out common complications of internal fistula,responsible stenosis and occlusion and intervene as early as possible,to provide effective guidance for further clinical treatment.

关 键 词：动静脉内瘘 血液透析 高频超声 并发症 

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