摘要
目的探讨尿毒症患者自体动静脉内瘘(AVF)建立血管条件的彩色多普勒超声评估及其成熟的超声因素。方法回顾性分析2020年1月至2023年1月于张家口市第一医院行血液透析治疗且建立AVF的194例尿毒症患者的临床资料,根据所选患者AVF术后6周的内瘘功能将其分为成熟组(149例)和未成熟组(45例)。所选患者均行彩色多普勒超声检查,分析影响尿毒症患者AVF成熟的单因素,用多因素Logistic回归分析影响尿毒症患者AVF成熟的危险因素。结果成熟组与未成熟组束臂前头静脉直径、束臂后头静脉直径、头静脉扩张性、桡动脉内径、桡动脉阻力指数(RI)、桡动脉舒张期峰值流速(EDV)、桡动脉收缩期峰值流速(PSV)、术后1 d肱动脉流量、术后1 d肱动脉PSV比较,差异有统计学意义(P<0.05)。多因素Logistic回归分析结果显示,束臂后头静脉直径小、头静脉扩张性小、桡动脉内径小、术后1 d肱动脉PSV慢是影响尿毒症患者AVF成熟的独立危险因素(OR=2.252、2.210、2.061、2.010,P<0.05)。结论彩色多普勒超声有利于评估尿毒症AVF患者内瘘血管形态及血流动力学,且束臂后头静脉直径小、头静脉扩张性小、桡动脉内径小、术后1 d肱动脉PSV慢是影响尿毒症患者AVF成熟的主要超声因素,可据此给予患者针对性预防对策,以促进尿毒症患者AVF成熟。
Objective To investigate the effect color doppler ultrasound evaluation of establishing vascular conditions for autologous arteriovenous fistula(AVF)in patients with uremia and study of mature ultrasound factors.Methods Retrospective analysis of the clinical data of 194 patients with uremic who underwent hemodialysis treatment and established AVF in our hospital from January 2020 to January 2023.They were divided into the mature group(149 cases)and the immature group(45 cases)based on the internal fistula function of the selected patients at 6 weeks after AVF surgery.All selected patients underwent color doppler ultrasound examination,the single factor affecting AVF maturation in patients with uremic were analyzed,and multiple Logistic regression analysis was used to identify the risk factors affecting AVF maturation in patients with uremic.Results There were statistically significant differences between the mature group and the immature group in the diameter of the anterior cephalic vein of the bundle arm,the diameter of the posterior cephalic vein of the bundle arm,the expansibility of the cephalic vein,the diameter of the radial artery,the resistance index(RI)of the radial artery,the peak diastole flow velocity(EDV)of the radial artery,the peak systolic flow velocity(PSV)of the radial artery,the flow volume of the brachial artery 1 d after the surgery,and the PSV of the brachial artery one day after the surgery(P<0.05).Multivariate Logistic regression analysis showed that small diameter of the cephalic vein behind the bundle arm,small dilatability of the cephalic vein,small diameter of the radial artery,and slow PSV in the brachial artery 1 d after surgery were independent risk factors affecting AVF maturity in patients with uremic(OR=2.252,2.210,2.061,2.010,P<0.05).Conclusion Color doppler ultrasound was conducive to evaluating the vascular morphology and hemodynamics of internal fistula in patients with uremic AVF,and small diameter of the cephalic vein behind the bundle arm,small dilatability of the cephalic vein,small diameter of the radial artery,and slow PSV in the brachial artery 1 d after surgery were the main ultrasound factors that affect the maturity of AVF in patients with uremic.Clinicians could give targeted preventive measures to patients according to this,so as to promote the maturity of AVF in patients with uremic.
作者
高宝琨
崔真
王静雯
袁志娟
戴学宇
孙海鹏
GAO Baokun;CUI Zhen;WANG Jingwen;YUAN Zhijuan;DAI Xueyu;SUN Haipeng(The First Hospital of Zhangjiakou City,Hebei 075000,China)
出处
《中国实验诊断学》
2023年第12期1425-1429,共5页
Chinese Journal of Laboratory Diagnosis
基金
张家口市重点研发计划项目(2221221D)
关键词
尿毒症
自体动静脉内瘘
血管条件
彩色多普勒超声
uremia
autologous arteriovenous fistula
vascular conditions
color doppler ultrasound
