摘要
目的探讨内瘘血管彩色多普勒超声检测在内瘘首次使用中的应用。方法 134例尿毒症患者在内瘘手术后30～40d、首次使用前进行内瘘血管彩色多普勒超声检测,根据内瘘血管彩色多普勒超声检测结果和患者内瘘的临床表现,评估内瘘功能和发育状况,从而判断内瘘穿刺的时机,选择合适的穿刺点和穿刺方向,选择首次使用血流量。结果 134例尿毒症患者内瘘,根据超声诊断结果和临床表现,120例患者内瘘功能发育正常,及时给予穿刺,穿刺成功,血流量符合使用要求。14例患者内瘘功能发育欠佳和发育不良,给予延迟10～30d穿刺,12例穿刺成功,血流量符合或基本符合要求。2例患者由于高龄、血管条件差、内瘘血流量不足、内瘘发育不良,延迟30d穿刺未成功,1例给予重新进行内瘘成形术,1例给予颈内静脉永久导管置管维持血液透析。讨论内瘘成型术后30～40d、首次使用前进行内瘘血管彩色多普勒超声检测,可客观判断内瘘功能,有助于选择内瘘穿刺时机,选择内瘘穿刺点及穿刺方向,对于保护内瘘、保证内瘘的血流量、提高透析效果、减少医患纠纷有很好的效果。
Objective To explore the application of internal fistula vascular color Doppler ul- trasound in primary puncture of internal fistula. Methods A total of 134 urinemia patients were administered color Doppler ultrasonic testing before primary puncture in 30 to 40 days after internal fistula surgery. According to the results of color Doppler ultrasonic testing, clinical manifestations of patients＇ internal fistulas as well as the function and development condition of internal fistula, we de- cided on the best time for fistula puncture and selected the appropriate puncture point, direction and primary quantity of blood flow. Results According to the ultrasonic diagnosis and clinical manifes- tations, 120 patients＇ fistula functions developed normally, so their punctures were implelnented successfully and timely. The blood flow conformed to the requirement. Another 14 patients＇ fistula functions developed poorly, thus we delayed the puncture for 10 to 30 days. Among the 14 pa- tients, 12 were punctured successfully and their blood flow conformed to the requirement, and the other 2 patients＇ punctures failed due to their old age, poor vascular conditions, insufficient blood flows and fistula dysplasia. As a result, one patient was implemented with internal fistula angioplasty while another patient received hemodialysis by permanent internal jugular venous catheterization. Conclusion Application of internal fistula vascular color Doppler ultrasonic testing in 30 to 40 days after internal fistula angioplasty can identify the function of the fistula objectively. It can not only make contribution to the selection of fistula puncture time, position and direction, but also pro- vide protections and guarantee for internal fistula and blood flow, improve dialysis effect and re- duce medical disputes.
出处
《实用临床医药杂志》
CAS
2012年第18期37-39,共3页
Journal of Clinical Medicine in Practice
基金
卫生部临床重点专科建设项目基金资助项目
关键词
内瘘
血管彩色多普勒超声检测
穿刺
应用
internal fistula
vascular color Doppler ultrasonic testing
puncture
application
