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大型血液透析单位如何开展内瘘每月血流量监测:一项横断面研究。

How to carry out monthly blood flow surveillance of fistula in large-scale hemodialysis units: A cross-sectional study.

作者信息

Mo Ya-Wen, Sun Chun-Yan, Song Li, Zhou Li-Fang, Zhuang Ting-Ting, Zhong Mi, Zheng Shu-Qian, Chen Ying-Gui, Chen Yuan-Han, Liu Shuang-Xin, Liang Xin-Ling, Fu Xia

机构信息

Division of Nephrology, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China.

School of Nursing, Southern Medical University, Guangzhou, China.

出版信息

J Vasc Access. 2021 Jan;22(1):75-80. doi: 10.1177/1129729820923939. Epub 2020 Jun 1.

Abstract

BACKGROUND

The important effect of regular blood flow surveillance on arteriovenous fistula maintenance is emphasized. The ultrasonic dilution technique for blood flow surveillance can be performed during hemodialysis, but there are some limitations. Blood flow is traditionally measured by duplex Doppler ultrasound during the nondialysis period. However, the surveillance workload for arteriovenous fistula has increased with the rapid increase in the hemodialysis population size. Efficient methods for blood flow surveillance during hemodialysis are needed.

METHODS

Eighty-four hemodialysis patients with a forearm radiocephalic arteriovenous fistula were enrolled in this cross-sectional study. Each received blood flow measurements using ultrasonic dilution technique and duplex Doppler ultrasound during hemodialysis. Duplex Doppler ultrasound measurements included the blood flow of the brachial artery and radial artery. The correlations between these variables were analyzed.

RESULTS

The correlation coefficients () between flow measured by ultrasonic dilution technique and brachial artery flow measured by duplex Doppler ultrasound, between flow measured by ultrasonic dilution technique and radial artery flow measured by duplex Doppler ultrasound, and between brachial artery flow and radial artery flow measured by duplex Doppler ultrasound were 0.724, 0.784, and 0.749, respectively (all < 0.001).

CONCLUSION

Blood flow measured by ultrasonic dilution technique was positively correlated with blood flow measured by duplex Doppler ultrasound during hemodialysis, suggesting that duplex Doppler ultrasound can be used to monitor the trends in the blood flow of the brachial artery and radial artery for timely intervention to improve patency during hemodialysis.

摘要

背景

强调了定期血流监测对动静脉内瘘维持的重要作用。用于血流监测的超声稀释技术可在血液透析期间进行,但存在一些局限性。传统上,在非透析期间通过双功多普勒超声测量血流量。然而,随着血液透析患者数量的迅速增加,动静脉内瘘的监测工作量也随之增加。需要在血液透析期间进行血流监测的有效方法。

方法

本横断面研究纳入了84例患有前臂桡动脉-头静脉内瘘的血液透析患者。每位患者在血液透析期间均使用超声稀释技术和双功多普勒超声进行血流量测量。双功多普勒超声测量包括肱动脉和桡动脉的血流量。分析了这些变量之间的相关性。

结果

超声稀释技术测量的血流量与双功多普勒超声测量的肱动脉血流量之间、超声稀释技术测量的血流量与双功多普勒超声测量的桡动脉血流量之间以及双功多普勒超声测量的肱动脉血流量与桡动脉血流量之间的相关系数分别为0.724、0.784和0.749(均P<0.001)。

结论

超声稀释技术测量的血流量与血液透析期间双功多普勒超声测量的血流量呈正相关,这表明双功多普勒超声可用于监测肱动脉和桡动脉的血流趋势,以便及时进行干预以提高血液透析期间的通畅率。

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