彩超在尿毒症患者自体动静脉内瘘建立中的应用

发布时间：2018-04-15 12:48

本文选题：彩超 + 自体动静脉内瘘　；参考：《第三军医大学学报》2017年07期

【摘要】：目的探讨彩超在尿毒症患者自体动静脉内瘘建立中的应用价值。方法回顾性分析2010年9月至2016年9月在西南医院肾科行自体动静脉内瘘手术的1 895例尿毒症患者的临床资料,其中男性984例,女性911例,年龄18~79岁,平均57.2岁。根据其术前有无彩超检查定位分为物理检查组及超声检查组,比较两组手术时间及切口大小、手术一次性成功率、术前定位与最终手术部位匹配率、术后1周内瘘闭塞率、术后1个月内瘘成熟率及2个月后内瘘可穿刺率。结果超声检查组手术一次性成功率为95.8%,术前定位与最终手术部位匹配率为99.7%,2个月后内瘘可穿刺率99.8%,均明显高于物理检查组(P0.05);手术时间为(63±18)min、手术切口为(3.1±0.4)cm,术后1周内瘘闭塞率3.9%,均明显低于物理检查组(P0.05);术后1个月内瘘成熟率因物理检查组未常规检查无法比较。结论彩超可显著提高尿毒症患者自体动静脉内瘘手术一次性成功率、减小手术切口、缩短手术时间、降低早期闭塞率,并且通过术后的早期监测可及时发现内瘘相关并发症。
[Abstract]:Objective to evaluate the value of color Doppler ultrasound in the establishment of autogenous arteriovenous fistula in uremic patients.Methods the clinical data of 1 895 patients with uremia who underwent autologous arteriovenous fistula from September 2010 to September 2016 in the Renal Department of Southwest Hospital were retrospectively analyzed, including 984 males and 911 females with an average age of 57.2 years (180-79 years).According to the localization of color ultrasound examination before operation, the two groups were divided into physical inspection group and ultrasonic inspection group. The operation time and incision size, the one-off success rate, the matching rate between preoperative location and final operation site, the rate of fistula occlusion within 1 week after operation were compared between the two groups.The mature rate of fistula was 1 month after operation and the puncture rate was 2 months later.Results the one time success rate of ultrasonic inspection group was 95.8%, the matching rate between preoperative location and final site was 99.7, the puncture rate of internal fistula was 99.8 after 2 months, which was significantly higher than that of physical inspection group (P 0.05), the operative time was 63 卤18 min, the incision was 3.1 卤0.4 cm, and the postoperative week was 1 week.The occlusion rate of internal fistula was significantly lower than that of physical inspection group (P 0.05), and the maturation rate of fistula within one month after operation could not be compared because of unroutine examination in physical inspection group.Conclusion Color Doppler ultrasound can significantly improve the success rate of autogenous arteriovenous fistula in uremia patients, reduce the incision, shorten the operation time and reduce the rate of early occlusion, and the complications related to internal fistula can be found in time by early monitoring after operation.
【作者单位】：第三军医大学西南医院肾科;第三军医大学西南医院超声科;
【分类号】：R445.1;R459.5

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