摘要
目的 研究血透用动静脉内瘘流量与其通畅性及透析效果之间的关系。方法 用彩色流速流量定量(CVIQ)对72个动静脉内瘘进行了78人次流量测定,其中自体血管动静脉内瘘(BresciaChimino内瘘)57个,人造血管内瘘15个。随访内瘘通畅性及血透流量能否达标。结果 根据血透流量及内瘘类型,将患者分为三组。血透流量≥200ml/min者归入A组(BresciaChimino内瘘)、B组(人造血管内瘘),<200ml/min者归入C组。A、B、C组CVIQ平均流量分别为663.4ml/min(177～1913ml/min)、931.5ml/min(270～1714ml/min)和210.7ml/min(53～952ml/min),三组人次分别为53、15、10。C组中8人次流量<150ml/min,在接受手术或溶栓治疗的5人次中3人次流量恢复,另3例未治疗者,内瘘或栓塞或透析效果不佳。1例原血透流量未达标,CVIQ检查后调整静脉穿刺部位,血透流量达标。结论 血透用动静脉内瘘流量<150ml/min,提示内瘘功能不佳,及时处理可延长内瘘使用时间。
Objective To study the relationship between volume flow and patency,dialysis effect of hemodialysis access.Methods Access flow was measured by using CVIQ 78 times in 72 patients with hemodialysis.There were 57 Brescia Chimino fistulas and 15 grafts.Patency,volume flow during hemodialysis were followed.Results According to volume flow during hemodialysis and types of access,they were devided into 3 groups.Access with volume flow during hemodialysis ≥200 ml/min was included into Group A(Brescia Chimino fistulas) and B (grafts).Those with flow less than 200 ml/min were included into group C.Mean volume flow of CVIQ measurement in group A,B,C was 663.4 ml/min (177～1 913 ml/min), 931.5 ml/min(270～1 714 ml/min) and 210.7 ml/min(53～952 ml/min),respectively;times of examination included in 3 groups were 53,15 and 10,respectively.In group C,there were 8 cases with access flow <150 ml/min,in which 3 accesses were salavaged in 5 patients who were subsequently revised,while 3 patients left unrevised either occluded or had poor effect of hemodialysis.Inicially,volume flow of hemodialysis of 1 patients was <200 ml/min,after CVIQ measurement,reselected one vein with high volume flow to puncture,and volume flow during hemodialysis can reach 200 ml/min.Conclusions Hemodialysis access with volume flow less than 150 ml/min have poor function if left untreated.Immediate revision can prolong hemodialysis access.CVIQ measurement can also help site selection of hemodialysis puncture.
出处
《中华超声影像学杂志》
CSCD
2000年第2期113-116,共4页
Chinese Journal of Ultrasonography
关键词
彩色多普勒
动静脉瘘
CVIQ
Ultrasonography,Doppler,color
Color velocity imaging quantification
Arteriovenous fistula
