彩色多普勒超声辅助动静脉内瘘位点图建立在内瘘绳梯穿刺中的应用  

Color Doppler ultrasound assisted Application of arteriovenous fistula site map in the establishment of internal fistula rope ladder puncture

作　　者：樊梅荣[1] 曾财花 殷鹭 陶玲玲[1] FAN Meirong;ZENG Caihua;YIN Lu;TAO Lingling(Intrarenal hemodialysis Center,the First Affiliated Hospital of Nanchang University,Jiangxi,Nangchang,330006,China)

机构地区：[1]南昌大学第一附属医院肾内血透中心,南昌330006

出　　处：《江西医药》2023年第12期1394-1398,共5页Jiangxi Medical Journal

基　　金：江西省卫健委课题,编号SKJP-220211850。

摘　　要：目的探讨在彩色多普勒超声辅助下评估动静脉内瘘血管,绘制动静脉内瘘位点图以指导护士绳梯穿刺。方法研究选取80例自体动静脉内瘘行维持性血液透析治疗的患者,通过随机数字法分成观察组与对照组各40例,观察组采用彩色多普勒超声辅助建立动静脉内瘘位点图指导绳梯穿刺法,对照组则通过传统方法评估动静脉内瘘进行绳梯穿刺。观察两组患者6个月内穿刺成功率、血流量不足发生率、24小时血肿发生率、绳梯穿刺执行率,两组患者分别在第3、6、9、12个月行彩色多普勒超声评估血管,评估血管狭窄、血栓、血管瘤样扩张并发症的发生率。结果绳梯穿刺的执行率观察组优于对照组(P<0.05);血流量不足发生率观察组小于对照组(P<0.05);患者动静脉内瘘位点图建立后的第6、9、12个月内瘘血管狭窄、血栓、血管瘤样扩张并发症的发生率观察组小于对照组(P<0.05)。结论利用彩色多普勒超声辅导动静脉内瘘位点图建立能够增加护士绳梯穿刺的执行率,降低动静脉内瘘血流量不足发生率,降低动静脉内瘘位点图建立后第6、9、12个月血管狭窄、血栓、血管瘤样扩张的并发症发生率。Objective To explore the evaluation of arteriovenous fistula vessels with the aid of color Doppler ultrasound,and to draw the site map of arteriovenous fistula to guide nurses in rope ladder puncture.Methods A total of 80 patients with autologous arteriovenous fistula undergoing maintenance hemodialysis were selected and divided into the observation group and the control group by random number method,with 40 cases in each group.The observation group was assisted by color Doppler ultrasound to establish arteriovenous fistula site map to guide rope ladder puncture,while the control group was evaluated by traditional methods for rope ladder puncture.The success rate of puncture within 6 months,the incidence of insufficient blood flow,the incidence of 24-hour hematoma and the execution rate of rope ladder puncture were observed in the two groups.The patients in the two groups were evaluated by color Doppler ultrasound at the 3rd,6th,9th and 12th months,respectively,to evaluate the incidence of vascular stenosis,thrombosis and Hemangiomatous dilation complications.Results The execution rate of rope ladder puncture in observation group was better than that in control group(P<0.05).The incidence of insufficient blood flow in observation group was lower than that in control group(P<0.05).The incidence of fistula stenosis,thrombosis and hemangiomatous dilation complications in the observation group was lower than that in the control group at 6,9 and 12 months after the establishment of the arteriovenous fistula site map(P<0.05).Conclusion The use of color Doppler ultrasound to guide the establishment of arteriovenous fistula site map can increase the performance rate of nurses'rope ladder puncture,reduce the incidence of insufficient blood flow in arteriovenous fistula,and reduce the incidence of complications of vascular stenosis,thrombosis and hemangiomatous dilatation at 6,9 and 12 months after the establishment of arteriovenous fistula site map.

关 键 词：彩色多普勒超声 动静脉内瘘 位点图 穿刺 

分 类 号：R473.5[医药卫生—护理学]