超声监测人工动静脉内瘘及其并发症的应用价值

目的探讨彩色多普勒超声监测血液透析动静脉内瘘及其并发症的应用价值。方法选取59例患者进行自体动静脉内瘘血管系统彩色多普勒超声检查,总结15例并发症患者声像图特征及相关临床处理情况。结果 （1）44例动静脉内瘘患者血流通畅,血流量正常,透析充分。（2）15例检测出并发症：5例血栓形成导致通路血管闭塞或重度狭窄;2例内瘘狭窄;1例瘘旁形成血肿导致通路外压性狭窄;2例形成假性动脉瘤;1例形成桡动脉真性动脉瘤;2例回流静脉形成瘤样扩张;2例出现盗血综合征。（3）将并发症分为3种类型。Ⅰ类：内瘘废用,须改建（建立新的血管通路）;Ⅱ类：须处理,在原血管通路基础上进行手术修复;Ⅲ类：无需处理,仅需观察。结论彩色多普勒超声监测动静脉内瘘及其并发症有很大临床价值。

Significance of ultrasound in monitoring the artificial arteriovenous fistula and its complications

Objective To explore the value of color Doppler ultrasound in the artificial arteriovenous fistula（AVF） on routine monitoring and complications treatment.Methods 59 patients with AVF were examined by color Doppler ultrasonograply.The ultrasonogram feature and clinical treatment of complications in 15 cases were analyzed retrospectively.Results（1）44 cases＇ flow volume of the fistula was fluent in 59 patients.（2）15 cases complications： thrombosis caused access occlusion or stenosis（n=5）;fistula stenosis（n=2）;hematoma formation caused access stenosis（n=1）;Pseudoaneurysms（n=2）,aneurysms of radial artery（n=1）;venous phlebangioma（n=2）;steal syndrome（n=2）.（3）complications were classified by 3 types,Ⅰ：AVF disused,which should be rebuild（construct new blood vessel）;Ⅱ：AVF should be repaired by operation（on the origin vessel）;Ⅲ：AVF need not operation in stead of observation.Conclusion Ultrasound has the desirable application value in monitoring the AVF as well as in diagnosing and treating complications.