刘晓明,谷颖,向明,车正兰,赵丽娜,宋文玉,刘宗旸
LIU Xiaoming,GUI Ying,XIANG Ming,CHE Zhenglan,ZHAO Lina,SONG Wenyu,LIU Zongyang

• 1:贵州医科大学附院超声中心
• 2:贵州医科大学附院肾内科
• 3:贵州省肿瘤医院

摘要(Abstract)：

目的:评价彩色多普勒超声检查在指导血液透析自体动静脉内瘘患者静脉狭窄或闭塞的诊断和治疗价值。方法:84例桡动脉-头静脉内瘘血液透析过程中发生头静脉狭窄或和闭塞的内瘘失功患者,采用彩色多普勒超声检查测量并标记狭窄或闭塞血管的部位、范围、狭窄程度及内径,同时观察同侧肢体无病变、可利用的其它血管;根据超声多普勒结果,选择自体血管移植术或贵要静脉转位重建术,术后随访6月~1年。结果:84例自体动静脉内瘘静脉狭窄或闭塞患者,超声检查发现狭窄59例,闭塞25例;根据超声检查结果行静脉移植搭桥术33例,贵要静脉转位51例,手术均顺利;术后随访,贵要静脉狭窄9例,贵要静脉血栓3例,其余病倒未见狭窄及血栓。结论:彩色多普勒超声在血液透析患者动静脉内瘘静脉狭窄范围和闭塞部位的定位,以及选取移植搭桥或转位静脉中有重要作用。
Objective: To discuss the application value of color Doppler ultrasonography in guiding clinical treatment for hemodialysis patients with venous stenosis or occlusion of autologous arteriovenous internal fistula. Methods: Eighty-four cases of patients with venous stenosis or occlusion of autogenous arteriovenous fistula( radial head-intravenous fistula) in hemodialysis were enrolled in this study. The color doppler ultrasound examination was adopted to measure and mark the position of stenosis or occlusion,scope,narrow degree inside diameter. Meanwhile,it was observed if there was ipsilateral limb lesions and there was available other blood vessel. According to the results of ultrasound examination,venous bypass grafting surgery or basilic vein transposition surgery was selected and postoperative follow-up lasted 6 months to 1 year. Results: Among 84 cases of autologous arteriovenous fistula stenosis or occlusion,there were 59 cases of stenosis and 25 cases of occlusion according to ultrasonic examination. According to the results of ultrasonic examination,33 cases of venous bypass grafting surgery and 51 cases of basilic vein transposition surgery were performed,all of which went on smoothly. All the patients were followed up after operation. Conclusion: The color Doppler ultrasound can play an important guiding significance in the treatment of patients with hemodialysis fistula.

关键词(KeyWords)： 彩色多普勒超声;动静脉内瘘;狭窄;闭塞
color Doppler ultrasound;arteriovenous fistula;stenosis;occlusion

Abstract:

Keywords:

基金项目(Foundation):

作者(Author): 刘晓明,谷颖,向明,车正兰,赵丽娜,宋文玉,刘宗旸
LIU Xiaoming,GUI Ying,XIANG Ming,CHE Zhenglan,ZHAO Lina,SONG Wenyu,LIU Zongyang

DOI: 10.19367/j.cnki.1000-2707.2015.10.026

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