彩色多普勒和血管超声造影指导困难动静脉内瘘的建立

目的总结彩色多普勒和血管超声造影指导困难动静脉内瘘建立的经验。方法2001年10月～2006年5月第三军医大学大坪医院肾内科、贵州水城矿业总医院血液净化中心和四川省通江县人民医院心肾科行血液透析的患者102例，分析彩色多普勒和血管超声造影指导这102例建立内瘘的部位、血管吻合方式和术中技巧等经验。结果102例经彩色多普勒和血管超声造影筛选均发现有可用于建立内瘘的静脉，部分有多条可用静脉，术中均用桡动脉移位至皮下与静脉进行吻合的术式，术后3月内瘘成功率100％，所有内瘘均能满足透析需要。结论彩色多普勒和血管超声造影是介指导困难内瘘建立的有效手段，动脉移位术式可提高困难内瘘建立的成功率。

Myocardial contrast echocardiography (MCE) creation of arteriovenous fistula in complicated blood vessel guided by color doppler and vascular contrast-enhanced ultrasonography

Objective To review the experience of creation of arteriovenous(AV) fistula in complicated blood vessel guided by color doppler and vascular contrast-enhanced ultrasonography.Methods A retrospective study was performed in 102 cases of patients undergoing maintenance hemodialysis(MHD) with autologous arteriovenous fistulas,which were created in complicated blood vessel guided with the by color doppler and vascular contrast-enhanced ultrasonography assessment during October,2001 to May,2006.The successful experience of the selected site,the vascular anastomosis modus operandi creating AV fistula such as the selection of location for AV fistula placement and the anastomosis technique and the surgical technique to AV fistula guided by color doppler and vascular contrast-enhanced ultrasonography in the 102 cases were analyzed.Results Veins,which can be used to create AV fistula were found by color doppler and vascular contrast-enhanced ultrasonography in all the 102 cases,and multi-vein several veins was found in partsome patients.Subcutaneouly transposition of radial artery to coincide anastomose the selected vein was the only way of creating AV fistula in the 102 cases,and all the created AV fistula were satisfied with the requirement of hemodialysis.Conclusion Color doppler and vascular contrast-enhanced ultrasonography is are useful means to guide the creation of AV fistula in complicated blood vessel patients with poor vascular conditions,the achievement ratio to the creation of AV fistula in complicated blood vessel these patients can be elevated thoroughly by the modus operandi anastomosis technique of radial artery transposition.