超声诊断技术在行AVF的ESRD患者人工动静脉血管通路术前功能评估、术后及时动态监测中的应用
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摘要
目的探讨超声诊断技术在行自体动静脉造瘘(AVF)的终末期肾脏疾病(ESRD)患者人工动静脉血管通路术前功能评估、术后及时动态监测中的临床应用价值。方法随机选择行血液透析治疗的ESRD患者60例,根据患者术后6～8周内临床透析穿刺检验结果分为观察组和对照组各30例。回顾性分析所有患者的血管超声诊断结果,观察两组患者手术前后的桡动脉、头静脉内径及其血流量。结果观察组患者手术前后的桡动脉内径、手术后的头静脉内径均高于对照组(P <0.05);观察组患者手术前后的桡动脉血流量、手术后头静脉血流量均高于对照组(P <0.05),观察组手术后的桡动脉血流量显著高于术前(P <0.05)。结论超声诊断技术在行AVF术的ESRD患者人工动静脉血管通路术前功能评估和术后监测中具有重要的临床应用价值,能够为确定术后瘘道是否可进行透析操作提供可靠依据,从而提高AVF的成功率,并为后续治疗方案的确定提供参考。
Objective To explore the clinical application value of ultrasound diagnosis technique in preoperative functional assessment and postoperative dynamic monitoring of artificial arteriovenous pathway in patients with end-stage renal disease(ESRD)underwent arteriovenous fistula(AVF). Methods 60 ESRD patients with hemodialysis were randomly selected. The patients were divided into observation group and control group according to the results of clinical dialysis puncture test within 6 to 8 weeks after operation. The vascular ultrasound diagnosis results of all patients were retrospectively analyzed, and the diameter and blood flow of radial artery and cephalic vein before and after operation were observed in both groups. Results The diameter of radial artery before and after operation, as well as the diameter of cephalic vein after operation in the observation group were higher than those in the control group(P <0.05). The blood flow of radial artery before and after operation, as well as the blood flow of cephalic vein after operation in the observation group were higher than those in the control group(P <0.05), and the blood flow of radial artery after operation was higher than that before operation in the observation group(P <0.05). Conclusions Ultrasound diagnosis technique has important clinical application value in functional assessment and postoperative dynamic monitoring of artificial arteriovenous pathway in ESRD patients with AVF, which can provide reliable basis for dialysis operation of postoperative fistula, so as to improve the success rate of AVF and provide reference for the establishment of follow-up treatment plan.
Objective To explore the clinical application value of ultrasound diagnosis technique in preoperative functional assessment and postoperative dynamic monitoring of artificial arteriovenous pathway in patients with end-stage renal disease(ESRD)underwent arteriovenous fistula(AVF). Methods 60 ESRD patients with hemodialysis were randomly selected. The patients were divided into observation group and control group according to the results of clinical dialysis puncture test within 6 to 8 weeks after operation. The vascular ultrasound diagnosis results of all patients were retrospectively analyzed, and the diameter and blood flow of radial artery and cephalic vein before and after operation were observed in both groups. Results The diameter of radial artery before and after operation, as well as the diameter of cephalic vein after operation in the observation group were higher than those in the control group(P <0.05). The blood flow of radial artery before and after operation, as well as the blood flow of cephalic vein after operation in the observation group were higher than those in the control group(P <0.05), and the blood flow of radial artery after operation was higher than that before operation in the observation group(P <0.05). Conclusions Ultrasound diagnosis technique has important clinical application value in functional assessment and postoperative dynamic monitoring of artificial arteriovenous pathway in ESRD patients with AVF, which can provide reliable basis for dialysis operation of postoperative fistula, so as to improve the success rate of AVF and provide reference for the establishment of follow-up treatment plan.
引文
[1]刘兴钊,胡青茂,黄永.超声在动静脉造瘘患者血管通路术前、术后动态监测中的应用[J].医学影像学杂志,2017,27(11):2214-2217.
[2]彭鑫,涂波,黄晓玲.彩色多普勒超声在动静脉内瘘中的临床应用价值[J].临床超声医学杂志,2015,17(4):261-262.
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[4]黄永,刘兴钊,黄蕊,等.超声诊断技术在终末期肾脏疾病动静脉造瘘中的临床应用价值[J].中国医药导报,2018,15(34):140-143.
[5]刘晓明,谷颖,向明,等.彩色多普勒超声评估行高位动静脉内瘘术及静脉浅置化患者血管的价值[J].贵阳医学院学报,2016,41(5):590-593.
[6]黄少敏,岑忠耿,张伟帅,等.彩色多普勒超声评估透析患者动静脉内瘘血栓及狭窄的临床价值[J].中国超声医学杂志,2016,32(1):31-33.
[7]苏善勇.彩色多普勒超声应用于动静脉内瘘血液透析通路患者中的价值评价[J].医学信息,2012,25(10):26-27.
[8]Silva MB Jr,Hobson RW,Pappas PJ,et al.A strategy for increasing use of autogenous hemodialysis access procedures:impact of preoperative noninvasive evaluation[J].J Vasc Surg,1998,27(2):302-308.
[2]彭鑫,涂波,黄晓玲.彩色多普勒超声在动静脉内瘘中的临床应用价值[J].临床超声医学杂志,2015,17(4):261-262.
[3]胡婉霞.血管超声对自体动静脉造瘘术前评估及术后随访的临床价值探讨[J].中国民间疗法,2016,24(7):85-86.
[4]黄永,刘兴钊,黄蕊,等.超声诊断技术在终末期肾脏疾病动静脉造瘘中的临床应用价值[J].中国医药导报,2018,15(34):140-143.
[5]刘晓明,谷颖,向明,等.彩色多普勒超声评估行高位动静脉内瘘术及静脉浅置化患者血管的价值[J].贵阳医学院学报,2016,41(5):590-593.
[6]黄少敏,岑忠耿,张伟帅,等.彩色多普勒超声评估透析患者动静脉内瘘血栓及狭窄的临床价值[J].中国超声医学杂志,2016,32(1):31-33.
[7]苏善勇.彩色多普勒超声应用于动静脉内瘘血液透析通路患者中的价值评价[J].医学信息,2012,25(10):26-27.
[8]Silva MB Jr,Hobson RW,Pappas PJ,et al.A strategy for increasing use of autogenous hemodialysis access procedures:impact of preoperative noninvasive evaluation[J].J Vasc Surg,1998,27(2):302-308.