彩色多普勒超声在血液透析动静脉内瘘功能评估及病变检测中的应用探究

目的:探讨彩色多普勒超声在血液透析动静脉内瘘功能评估及病变检测中的应用价值。方法:选取2013年3月至2016年3月于我院接受血液透析的终末期肾病患者62例作为研究对象,采用二维超声观察动静脉内瘘的一般情况,采用彩色多普勒观察血流方向、速度以及充盈情况,对检测结果进行比较。结果:自体动静脉内瘘成形术后桡动脉管径(RAD)、桡动脉血流量(RVF)、头静脉管径(CVD)均较术前有所提高,各项指标随时间延长而逐渐增高,差异有统计学意义(P0.05)。62例血液透析患者中,共有41例(66.13%)患者动静脉内瘘通畅,21例(33.87%)患者出现动静脉内瘘并发症,其中血栓形成9例(14.52%)、动静脉瘘狭窄7例(11.29%)以及静脉瘤状扩张5例(4.84%)。血栓形成组头静脉血管内径(D)、吻合口D、最大峰值流速(PSV)及血流阻力指数(RI)、桡动脉D、PSV及RI均较正常组有显著差异。血栓形成、动静脉瘘狭窄患者上述参数及血流量与正常组比较有显著差异(P0.05)。结论:彩色多普勒超声可有效监测血液透析患者动静脉内瘘病变发生情况,对其结构功能进行直接观察的同时还可明确诊断动静脉内瘘并发症。

Application Value of CDFI in the Evaluation and Dseases Dtection of Ateriovenous Fstula

ABSTRACT Objective: To explore the application value of colored doppler ultrasound in the evaluation and diseases detection of arteriovenous fistula. Methods: 62 ESRD patients underwent hemodialysis in our hospital from Mar.2013 to Mar.2016 were selected and detected by colored doppler ultrasound. Two-dimensional ultrasound was using for general detection of arteriovenous fistula, CDFI was using for detection of blood flow, velocity and filling. Then the indexes of detection were compared. Results: RAD, RVF and CVD after arteriovenostomy wer getting higher than before and improved as time prolonged (P<0.05). There were 41 cases (66.13%) with fluent flow of arteriovenous fistula, 21 cases (33.87%) with complications, among them were 9 cases (14.52%) DVT, 7 cases (11.26%) stenosis and 5 cases (4.84%) expansion. The diameter of cephalic vein, diameter, PSV and RI of anastomosis and radial artery of thrombosis group were all had differences with normal group. The indexes above and blood flow of patients with complications had great differences compared to normal group (P<0.05). Conclusion: Using color doppler ultrasound could survillance the diseases of arteriovenous fistula of patients underwent hemodialysis, which could directly observe the structure and function .