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[上肢彩色多普勒在血液透析动静脉内瘘建立前的作用]

[The role of arms color Doppler before creation arteriovenous fistula for hemodialysis].

作者信息

Varlaj-Knobloch Vesna, Krnić Anton, Orsanić-Brcić Dubravka, Marinković Davor

机构信息

Poliklinika "Sveti Duh 2", Zagreb.

出版信息

Acta Med Croatica. 2008;62 Suppl 1:82-5.

Abstract

PURPOSE

our experience with color Doppler of arms blood vessels before creation arteriovenous fistula for hemodialysis.

PATIENTS AND METHODS

three years ago all patients who need surgery creation of arteriovenous fistula had Doppler ultrasound preoperative vascular mapping. Purpose of the view is to take a picture of proximal and distal part of arteria radials both arms, distal part of venous cephalica and proximal part of venous mediana antebrachii. We must know if these blood vessels have good morphological and hemodinamic criteria for creation arteiovenous fistula.

RESULTS

in the study were twenty patients, creation of AV fistula was unsuccessful by two patients, but ultrasonic doctor had warning on very gracile blood vessels; by 18 patients in period of 2 to 36 months (mean 12.2 moths) we have optimal effective flow through dialysis filter 300 ml/min, and they are still in good function.

SUMMARY

carefully blood vessels review with color Doppler before creation arteriovenous fistula for hemodialysis, and marking suitable blood vessels with marker on the skin under sonography control reduced unsuccessful number of surgery exploration and destruction of blood vessels if AV fistula don't work. This is very important for hemodialysis patients, especially for diabetics.

摘要

目的

我们在为血液透析建立动静脉内瘘之前,运用彩色多普勒对上肢血管进行检查的经验。

患者与方法

三年前,所有需要进行动静脉内瘘手术的患者均接受了术前血管多普勒超声检查。检查目的是获取双臂桡动脉近端和远端、头静脉远端以及前臂正中静脉近端的图像。我们必须了解这些血管是否具备建立动静脉内瘘良好的形态学和血液动力学标准。

结果

该研究中有20名患者,2例患者动静脉内瘘建立失败,但超声医生已就血管极为纤细发出警告;18例患者在2至36个月(平均12.2个月)期间,通过透析滤器的有效血流量达到最佳,为300毫升/分钟,且功能仍然良好。

总结

在为血液透析建立动静脉内瘘之前,运用彩色多普勒仔细检查血管,并在超声控制下在皮肤上用标记物标记合适的血管,可减少手术探查失败的次数,以及在动静脉内瘘不起作用时对血管的破坏。这对血液透析患者,尤其是糖尿病患者非常重要。

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