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彩色超声引导肱动脉内瘘穿刺置管术。

In-plane guided upper arm arteriovenous fistula cannulation with color ultrasound.

机构信息

Department of Hemodialysis, WuHan No. 1 Hospital, WuHan, Hubei, China.

Department of Equipment Section, WuHan No. 1 Hospital, WuHan, Hubei, China.

出版信息

Hemodial Int. 2022 Oct;26(4):496-502. doi: 10.1111/hdi.13043. Epub 2022 Sep 6.

DOI:10.1111/hdi.13043
PMID:36068186
Abstract

BACKGROUND

The blood vessel in the upper extremity arteriovenous fistula (AVF) is deep in the tissue, and cannulation in AVF is frequently associated with blood oozing, hematoma, or aneurysm. This study evaluated the performance of color ultrasound in-plane guided cannulation technique during upper extremity high-AVF cannulation in patients with hemodialysis.

METHODS

A total of 40 patients with hemodialysis who needed cannulation in upper extremity AVF were recruited in the study, and the patients were randomly divided into observation group and control group. Color Doppler ultrasound was used to guide cannulation in the observation group and in the control group blind cannulation method was applied. The success rate of one-time cannulation, the incidence of subcutaneous hematoma, oozing, and pain caused by incorrect fistula cannulation as well as the satisfaction score of the patients were compared to evaluate the effect and advantages of color ultrasound-guided cannulation.

RESULTS

The one-time success rate of internal fistula cannulation in the observation group (98.71%) was significantly higher than that in the control group (88.27%). The incidence rates of hematoma, oozing, pain, and total failure events were significantly reduced in the observation group. The average satisfaction degree in the observation group was also significantly higher than that of the control group.

CONCLUSION

Ultrasonic-guided cannulation effectively enhances the success rate of cannulation in upper extremity AVF, reduces the incidence of cannulation failures, and improves the satisfaction level in the patients.

摘要

背景

上肢动静脉内瘘(AVF)的血管位于组织深部,在 AVF 进行置管时常伴有渗血、血肿或动脉瘤。本研究评估彩色超声平面内引导置管技术在上肢高位 AVF 置管中的应用效果。

方法

共纳入 40 例需在上肢 AVF 进行置管的血液透析患者,采用随机数字表法将患者分为观察组和对照组。观察组采用彩色多普勒超声引导置管,对照组采用盲穿置管法。比较两组一次性置管成功率、皮下血肿、渗血、误穿瘘管引起的疼痛及患者满意度评分,以评估彩色超声引导置管的效果和优势。

结果

观察组内瘘一次穿刺成功率(98.71%)明显高于对照组(88.27%),观察组血肿、渗血、疼痛及总失败事件发生率均明显降低,观察组平均满意度也明显高于对照组。

结论

超声引导置管可有效提高上肢 AVF 置管成功率,降低置管失败发生率,提高患者满意度。

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