摘要
目的 探讨高频彩色多普勒超声在血液透析患者自体动静脉内瘘并发症诊断及临床治疗策略中的应用价值。方法 用高频彩色多普勒超声检查111例临床诊断动静脉内瘘功能不良的血液透析患者,通过高频超声观察桡动脉、头静脉及瘘口处的二维结构及血流特征,分析动静脉内瘘失功的原因。结果 在111例动静脉内瘘失功的患者中,发现狭窄50例(45.05%),其中头静脉狭窄34例,桡动脉狭窄8例,头静脉、桡动脉均存在狭窄1例;吻合口狭窄7例;血栓形成32例(28.83%),其中头静脉血栓20例(合并闭塞3例),瘘口处血栓9例,桡动脉血栓3例;狭窄合并血栓18例(16.21%);动脉瘤形成合并狭窄及血栓6例(5.41%),窃血综合征5例(4.50%),根据内瘘失功的时间及症状,结合超声报告,临床给予每位患者制定个性化治疗方案。结论 高频彩色多普勒超声在血液透析自体动静脉内瘘失功病因的诊断中具有重要的临床应用价值,能指导临床采取有效的治疗措施,挽救动静脉瘘功能,提高患者透析质量。
Objective To investigate the application value of high frequency ultrasound in clinical diagnosis and treatment of the complications of autologous arteriovenous internal fistula in patients undergoing hemodialysis.Methods A total of 111 patients with arteriovenous fistula dysfunction who were diagnosed by high-frequency color Doppler ultrasonography and underwent hemodialysis in our hospital were enrolled in the study.The two-dimensional structure and blood flow characteristics of the radial artery,cephalic vein and fistula were observed by high-frequency ultrasound,moreover,the reason of dysfunctioning autologous arteriovenous fistula was analyzed.Results Among the 111 patients with arteriovenous fistula dysfunction,stenosis was found in 50 cases(45.05%),of whom,there were 34 cases of cephalic vein stenosis,8 cases of radial artery stenosis,1 case of stenosis of the cephalic vein and radial artery.There were 7 cases of anastomotic stoma stenosis and 32 cases(28.83%)of thrombosis,of whom,there were 20 cases of cephalic venous thrombosis(3 cases with occlusion),9 cases of fistula thrombosis,3 cases of radial artery thrombosis,and 18 cases of stenosis complicated with thrombus(16.21%);6 cases(5.41%)of aneurysm with stenosis and thrombosis,5 cases of steal syndrome(4.50%).According to the time and symptoms of arteriovenous fistula dysfunction,combining with ultrasound results,every patient was treated by a personalized treatment plan.Conclusion The high-frequency color Doppler ultrasonography has important clinical application value in the diagnosis of hemodialysis autologous arteriovenous internal fistula dysfunctioning,which can guide clinical effective treatment,save the arteriovenous fistula function and improve dialysis quality.
作者
焦荣红
孙丽
高洁
邹伟妍
王超
JIAO Ronghong;SUN Li;GAO Jie(Department of Ultrasound Diagnosis,Hebei Provincial People’s Hospital,Hebei,Shijiazhuang 050051,China)
出处
《河北医药》
CAS
2019年第19期2914-2917,共4页
Hebei Medical Journal
基金
国家自然科学基金(编号:81370900)
河北省医学科学研究重点课题计划指令性课题(编号:ZL20140093)
关键词
高频彩色多普勒超声
自体动静脉内瘘
并发症
失功
治疗策略
high frequency color Doppler ultrasound
autologous arteriovenous internal fistula
complications
dysfunctioning
therapeutic strategy
