B-Flow技术在尿毒症患者人工造瘘血管监测的应用价值

目的 探讨二维血流显示（B-Flow)技术在肾衰血透患者动静脉瘘中的应用价值。方法 本文对31例尿毒症患者人工动静脉瘘进行超声检查，分别采用CDFI、PDI和B-Flow三种模式显示瘘口和动静脉侧血管情况，郑重观察吻口和动静脉侧血管形态、管壁情况以及管腔内血流显示情况。并进行血流动力学检测。结果 本组病例共３例检查对象，端端吻合２例，人造血管吻合３例，吻合口平均内径５mim。吻合口狭窄６例、血栓形成４例。Ｂ－Ｆlow技术能同时清晰显示血流和邻近背景组织。与ＣＤＦＩ、ＰＤＩ结合使用可提高异常图像显示率。Ｂ－Ｆlow与ＣＤＦＩ、ＰＤＩ比较，具有更高帧频、高分辨力和全景显示功能。结论 B-Flow技术是监测血透患者治疗过程中造瘘血管善的有效的辅助检测手段之一。动静脉瘘主要并发症是吻合口狭窄、静脉段瘤样扩张和血栓形成。

Value of B-Flow Technique Using in Artificial Fistula in Patients with Uremia

Purpose To explore and understand the practical value with B Flow in arteriovenous fistula hemodialysis patients with uremia. Methods 31 cases were examined with upper limbs arteriovenous fistulas with uremia and analyzed by CDFI, PDI and B Flow. It is important to observe conformation of fistula and blood vessel and examine changes on hemodynamics. Results Among 31 patients,23 patients were operated with end to end anastomoses, 3 cases with end to side anastomoses, 2 cases with manmade blood vessels. The average diameter of anastomoses orifice is 5mm. Six cases with anastomoses stenosis and 4 cases with thrombus formation. B Flow technique can display blood flow and background tissue distinctly at the same time. B Flow include wide bandwidth, high frame rate and high dynamic range for high spatial, temporal and contrast resolution imaging, respectively. Conclusion B Flow is an effective supplementary detective methods in treating hemodialysis patients with uremia. The main complication involved in is anastomoses stenosis, venus dilatation and anastomoses stricture associated with thrombus happened in individual case.