慢性肾衰竭患者血管造瘘后盗血综合征彩色多普勒超声特征

目的 探讨慢性肾衰竭患者血管造瘘后盗血综合征的彩色多普勒超声特征。方法 对87例慢性肾衰竭血管造瘘患者进行彩色多普勒超声检查,观察瘘口及距瘘口5 cm内桡动脉、尺动脉和头静脉血流充盈情况及血流方向,回顾患者前臂中部头静脉血流量。结果 87例患者中,79例(79/87,90.80%)超声示桡动脉远端至瘘口处出现反向血流,其中5例(5/79,6.33%)临床诊断为盗血综合征;5例盗血综合征患者中,3例超声发现桡动脉管腔狭窄。术后1个月时79例反向血流患者前臂中部头静脉平均血流量为(481.24±84.21)ml/min,5例盗血综合征患者血流量分别为900、423、416、461和405 ml/min。结论 动脉狭窄及头静脉的高血流量可能为慢性肾衰竭血管造瘘患者出现盗血综合征的原因,彩色多普勒超声可为此类患者的临床诊断和治疗提供有价值的参考。

Color Doppler ultrasonography features of steal ischemic syndrome in chronic renal failure patients with arteriovenous fistulae

Objective To explore the color Doppler ultrasonography features of steal ischemic syndrome in chronic renal failure patients with arteriovenous fistulae. Methods Totally 87 chronic renal failure patients with arteriovenous fistulae underwent color Doppler ultrasonography. The blood flow of arteriovenous fistulae, and radial artery, ulnar artery and cephalic vein within 5 cm away from the fistulae were examined. The blood flow volume of cephalic vein at the middle of forearm was restospected. Results Among 87 patients, reversed flow in the radial artery distal to the arteriovenous fistulae was found in 79 cases (79/87, 90.80%), in them 5 (5/79, 6.33%) were clinically diagnosed with steal ischemic syndrome. Stenosis of radial artery were found in 3 cases among the 5 steal ischemic syndrome patients. At 1 month after operation, the average blood flow volume of cephalic vein at the middle of forearm was (481.24±84.21)ml/min in 79 cases with reversed flow and 900, 423, 416, 461, 405 ml/min in 5 cases with steal ischemic syndrome. Conclusion Arterial stenosis and high blood flow volume of cephalic vein may be the reasons of steal ischemic syndrome, and color Doppler ultrasonography can provide useful reference for clinical diagnosis and treatment.