Ultrasound Laboratory, Takahashi Kazuyuki Clinic, Osaka, Japan.
Department of Urology, Sakaiheisei Hospital, Osaka, Japan.
J Med Ultrason (2001). 2022 Oct;49(4):619-627. doi: 10.1007/s10396-021-01161-8. Epub 2021 Nov 26.
When vascular access (VA) for hemodialysis is established using an autologous fistula or synthetic graft, repeated damage from needle insertion at each dialysis session can lead to thrombosis, resulting in vascular stenosis or occlusion that can cause poor blood removal, elevated venous pressure, and other impairments of blood flow. Compact, high-performance ultrasound devices have been developed in recent years. Such devices are used for point-of-care ultrasound (POCUS), which has been used on many occasions for emergency evaluation in the dialysis room and is becoming an important tool in VA management. POCUS provides a wealth of imaging information, such as needle position, whether the needle is inside or outside the blood vessel, and lesion position, width, and depth. This allows clinicians to detect VA problems early and take suitable measures, such as changing the cannulation site, thereby avoiding the need for unnecessary and highly invasive angiography or surgical procedures.
当通过自体动静脉瘘或人工移植物建立血液透析的血管通路时，每次透析时由于针插入而导致的反复损伤可能导致血栓形成，从而导致血管狭窄或闭塞，这可能导致血液清除不良、静脉压升高以及其他血流损伤。近年来，已经开发出了紧凑、高性能的超声设备。这些设备用于即时护理超声（POCUS），它已经在许多情况下用于透析室的紧急评估，并且正在成为血管通路管理中的重要工具。POCUS 提供了丰富的成像信息，例如针的位置、针是否在血管内或血管外以及病变的位置、宽度和深度。这使临床医生能够及早发现血管通路问题，并采取适当的措施，例如改变插管部位，从而避免不必要的和高度侵入性的血管造影或手术。
