临床内科杂志 ›› 2019, Vol. 36 ›› Issue (10): 676-679.doi: 10.3969/j.issn.1001-9057.2019.10.009

• 论 著 • 上一篇    下一篇

彩色多普勒血流显像测量同侧肱动脉血流速预测自体动静脉内瘘成熟度的研究

  

  • 出版日期:2019-10-15 发布日期:2019-10-30
  • 基金资助:
    北京清华长庚医院青年启动基金资助项目(12015C1008)

Prediction of maturation of autologous arteriovenous fistula by measuring the blood flow velocity of ipsilateral brachial artery with color Doppler flow imaging

  • Online:2019-10-15 Published:2019-10-30

摘要: 目的 探讨彩色多普勒血流显像(CDFI)测量同侧肱动脉血流速与自体动静脉内瘘(AVF)成熟的相关性。方法 选择2015年12月~2018年8月于我院行头静脉-桡动脉端侧吻合且术后触诊震颤明显的患者141例,收集其临床资料,对AVF前后CDFI检查结果进行比较。结果 141例患者中有116例患者内瘘成熟(成熟组),25例内瘘成熟不良(成熟不良组)。成熟不良组患者糖尿病患病率和糖尿病肾病为原发病的比例高于成熟组(P<0.05);成熟组患者术前头静脉直径大于成熟不良组(P<0.05);内瘘成熟组患者术后8周瘘口直径、肱动脉直径、肱动脉最大血流速和肱动脉血流速变化均高于成熟不良组(P<0.05)。结论 术后早期采用CDFI测定肱动脉直径、肱动脉最大血流速及肱动脉流速变化可预测内瘘是否成熟,用于早期发现内瘘成熟不良。

关键词: 自体动静脉内瘘; 内瘘成熟; 肱动脉血流速; 彩色多普勒血流显像

Abstract: Objective To explore the correlation between brachial artery blood flow velocity measured by color Doppler flow imaging (CDFI) and maturation of autologous arteriovenous fistula (AVF).Methods Clinical data of 141 patients who underwent end to side cephalic radial anastomosis was collected from December 2015 to August 2018 in our hospital.A comparative study of CDFI results before and after AVF was performed.Results Among 141 patients,116 AVF cases achieved maturation successfully(mature group)and 25 cases did not achieve maturation(immature group).The prevalence of diabetes mellitus and the proportion of diabetic nephropathy as primary diseases in immature group were higher than those in mature group(P<0.05).The diameter of cephalic vein in mature group was higher than that in immature group before operation.At 8 weeks after operation,the diameter of fistula anastomosis,diameter of brachial artery,max blood flow velocity of brachial artery and flow velocity change of brachial artery in mature group ware all higher than those in immature group(P<0.05).Conclusion The diameter of brachial artery,max blood flow velocity of brachial artery and flow velocity change of brachial artery are measured early after operation can forecast the maturity of internal fistula and find the immature internal fistula early.

Key words: Arteriovenous fistula; Internal fistula maturity; Blood velocity of brachial artery; Color Doppler flow imaging