| 摘要: |
| 目的 探讨超声在慢性肾衰竭患者自体动静脉内瘘（AVF）成形术后1 d评估中的临床应用价值。方法 选取我院行AVF成形术的慢性肾衰竭患者147例，术后1 d均行超声检查获得头静脉内径（CVD）、桡动脉内径（RAD）、肱动脉流量（FV），评估AVF是否发生并发症并以此进行分组；术后6周评估AVF是否成熟。比较AVF结构正常组与并发症组、AVF结构正常组中AVF成熟者与未成熟者一般资料和超声参数的差异；绘制受试者工作特征（ROC）曲线评价超声参数预测AVF成熟的效能。结果 147例AVF患者根据AVF成形术后1 d并发症发生情况分为AVF结构正常组116例和并发症组31例。两组年龄、性别比、原发病因、手术部位、手术方式、RAD比较差异均无统计学意义；CVD、肱动脉FV比较差异有统计学意义（均P＜0.001）。AVF结构正常组中AVF成熟者（95例）与未成熟者（21例），AVF成熟者与未成熟者年龄、性别比、手术部位、手术方式、CVD、RAD比较差异均无统计学意义；原发病因、肱动脉FV比较差异均有统计学意义（均P＜0.05）。ROC曲线分析显示，AVF成形术后1 d肱动脉FV预测AVF成熟的曲线下面积为0.899（95%可信区间：0.840～0.958，P＜0.001），截断值为407 ml/min，灵敏度和特异度分别为0.863、0.857。结论 应用超声有助于及时发现慢性肾衰竭患者AVF成形术后1 d并发症情况，且肱动脉FV＞407 ml/min时在预测AVF成熟中有一定的临床价值。 |
| 关键词: 超声检查 慢性肾衰竭 动静脉内瘘 并发症 成熟 |
| DOI： |
| 投稿时间：2023-12-23修订日期：2024-06-07 |
| 基金项目:重庆市技术创新与应用发展专项重点项目(CSTB2022TIAD-KPX0153) |
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| Application value of ultrasound examinationindex on the first day after arteriovenous fistula creation in patients with chronic renal failure |
| SHU Qipei,ZHANG Jun,YIN Na,ZHANG Jun,SHI Lin,YAN Ling,GUO Yanli |
| () |
| Abstract: |
| Objective To analyze the value of ultrasound examinationindex on the first day after arteriovenous fistula creation in patients with chronic renal failure.Methods A total of 147 patients with chronic renal failure who needed autologous arteriovenous fistuloplasty in our hospital were selected. Ultrasound on the 1 day after operation for arteriovenous fistula（AVF）to obtained cephalic vein diameter (CVD), radial artery diameter (RAD), brachial artery blood flow volume(FV).complications of arteriovenous fistula(AVF).Evaluation the complications of arteriovenous fistula(AVF) and divided into normal arteriovenous fistula structure group and complications group.All patients underwent AVF maturation evaluation 6 weeks after surgery.patients''general data and ultrasound examinationindex were compared between normal arteriovenous fistula structure group and complications group，the mature group and immature group of the normal arteriovenous fistula structure were also compared. Receiver operating characteristic（ROC）curve was drawn to evaluate the diagnostic accuracy of ultrasound examinationindex in predicting maturation of AVF.Results Among these 147 patients，divided into normal arteriovenous fistula structure group(n=116)and complications group(n=31)according to AVF complications.There were no statistically significant differences between the two groups in age, gender ratio,primary diseases，surgical site,surgical methods,and RAD.CVD,brachial artery blood flow volume were different between the two groups(all P<0.001).Among these 116 normal arteriovenous fistula structure patients,divided into mature group(n=95)and immature group(n=21)according to AVF maturation evaluation 6 weeks after surgery.There were no significant differences in age, gender ratio,surgical site,surgical methods,CVD,and RAD between mature group and immature group.Primary diseases and brachial artery blood flow volume were different between mature group and immature group(all P<0.05).The AUC of brachial artery blood flow volume to predict AVF maturation was 0.899（95%CI 0.840～0.958，P＜0.001），the best cut-off value of brachial artery blood flow volume was 407ml/min.with the sensibility and specificity of 86.3% and 85.7%.Conclusion First day after arteriovenous fistula creation in patients with chronic renal failure，ultrasound helps to early diagnosis the complications of AVF，and brachial artery blood flow volume ＞407 ml/min has some value in predicting the maturation of AVF. |
| Key words: Ultrasonography Chronic renal failure Arteriovenous fistula Complication Maturation |
