血管透析通路血流测量：通过早期检测进行早期干预。
Vascular dialysis access flow measurement: early intervention through early detection.
作者信息
Miguel Susana San, Chow Josephine
机构信息
Area Renal Service, Western Zone, Sydney South West Area Health Service, Sydney, Australia.
出版信息
J Ren Care. 2009 Dec;35(4):185-91. doi: 10.1111/j.1755-6686.2009.00114.x.
AIM
The aim of the project is to determine the effectiveness of using online access flow measurement, thermodilution method (Fresenius BTM), in detecting and predicting thrombosis or stenosis of the haemodialysis fistula, so that early intervention could be instituted.
METHODOLOGY
All haemodialysis patients with permanent vascular dialysis access, either arteriovenous fistula (AVF) or arteriovenous fistula graft (AVG), in a large tertiary referral Dialysis Service in Australia were included in this prospective observational quality project, conducted over 12 months.
RESULTS
Out of 165 patients studied, 36 patients were found to have poor dialysis access flow, defined as AVF--flow of <200 ml/min or a decrease of 25% from last measurement or AVG--flow of <600 ml/min or a decrease of 25% from last measurement. Doppler ultrasounds were performed, and confirmed findings of significant stenosis, either on the arterial or venous sites, as indicated by poor dialysis access flow results.
CONCLUSION
Thermodilution technique is a reliable and effective method of detecting poor dialysis access flow for patients with permanent vascular access, comparable with other techniques.
目的
本项目旨在确定使用在线血流测量（热稀释法，费森尤斯BTM）检测和预测血液透析动静脉内瘘血栓形成或狭窄的有效性，以便能够尽早进行干预。
方法
在澳大利亚一家大型三级转诊透析服务机构中，所有拥有永久性血管透析通路（动静脉内瘘或动静脉移植物内瘘）的血液透析患者均纳入本前瞻性观察性质量项目，该项目为期12个月。
结果
在研究的165例患者中，有36例患者的透析通路血流量不佳，定义为动静脉内瘘血流量<200 ml/min或较上次测量值下降25%，或动静脉移植物内瘘血流量<600 ml/min或较上次测量值下降25%。进行了多普勒超声检查，结果证实，透析通路血流量不佳表明在动脉或静脉部位存在明显狭窄。
结论
热稀释技术是一种检测永久性血管通路患者透析通路血流量不佳的可靠且有效的方法，与其他技术相当。
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