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[血液透析血管通路血流量评估不同技术的比较:血液温度监测热稀释法与多普勒测流法]

[Comparison of different techniques of hemodialysis vascular access flow evaluation: blood temperature monitoring thermodilution and doppler debimetry].

作者信息

Sacquépée Mathieu, Tivollier Jean-Michel, Doussy Yves, Quirin Nicolas, Valéry Jean-Claude, Cantin Jean-François

机构信息

Hémodialyse, association pour le traitement de l'insuffisance rénale en Nouvelle-Calédonie (ATIR NC), 193, rue Benebig, Vallées-des-Colons, BP 3996, 98846 Nouméa cedex, Nouvelle-Calédonie.

出版信息

Nephrol Ther. 2012 Apr;8(2):96-100. doi: 10.1016/j.nephro.2011.09.001. Epub 2011 Oct 22.

Abstract

BACKGROUND

Access blood flow measurements are considered useful indicators for thrombosis prevention. It was the purpose of this study to compare measurements of access blood flow by two different techniques: duplex doppler and BTM thermodilution.

METHODS

Patients included must be on chronic hemodialysis on arterioveinous vascular access. They must be in a unit fit with hemodialysis generator equipped with BTM tool. The measurements of access blood flow were made during the first hour of the hemodialysis session. A measurement with each technique was performed for each patient.

RESULTS

Fifteen patients were included: seven men and eight women, average age 60.8 ± 9.2 years, average weight 76 ± 16 kg, duration on hemodialysis therapy 6.6 ± 6.1 years. Access blood flow was native fistula (14 patients) and a prothetic access (one patient). Average access blood flow was 1088 ± 586 mL/mn (doppler) and 1094 ± 570 mL/mn (BTM). Comparison of access flows obtained by the BTM and doppler techniques showed a strong linear relationship. The average time to perform a measure was six minutes for the doppler technique and five minutes for the BTM technique. No adverse effect was observed in our study.

CONCLUSION

Our study shows a strong correlation between the two techniques (doppler and BTM) for the measurement of hemodialysis access blood flow. The BTM access blood flow measurement technique is fast, economic and made during the hemodialysis session by the nurse.

摘要

背景

动静脉内瘘血流量测量被认为是预防血栓形成的有用指标。本研究旨在比较两种不同技术测量动静脉内瘘血流量的结果:双功多普勒和BTM热稀释法。

方法

纳入的患者必须正在接受动静脉血管通路的慢性血液透析治疗。他们必须在配备有BTM工具的血液透析设备的科室。血流量测量在血液透析治疗的第一个小时内进行。对每位患者分别使用两种技术进行测量。

结果

共纳入15例患者,其中男性7例,女性8例,平均年龄60.8±9.2岁,平均体重76±16kg,血液透析治疗时间6.6±6.1年。内瘘类型为自体动静脉内瘘(14例)和人工血管动静脉内瘘(1例)。平均血流量为:双功多普勒测量值为1088±586mL/分钟,BTM测量值为1094±570mL/分钟。BTM技术和双功多普勒技术测得的血流量比较显示出很强的线性关系。双功多普勒技术测量平均耗时6分钟,BTM技术测量平均耗时5分钟。本研究中未观察到不良反应。

结论

我们的研究表明,双功多普勒和BTM这两种技术在测量血液透析动静脉内瘘血流量方面具有很强相关性。BTM血流量测量技术快速、经济,且可由护士在血液透析过程中完成。

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