| 陶杰,张凡,冯谦,王涛,吴晓波,孙菲菲.慢性肾衰竭患者前臂内瘘相关血管解剖的超声检查[J].中国医学影像技术,2016,32(5):737~740 |
| 慢性肾衰竭患者前臂内瘘相关血管解剖的超声检查 |
| Ultrasonograghy in dissection of forearm internal fistula-related blood vessels in patients with chronic renal failure |
| 投稿时间：2015-07-01 修订日期：2016-03-04 |
| DOI：10.13929/j.1003-3289.2016.05.026 |
| 中文关键词: 超声检查 血液透析 动静脉内瘘 桡动脉 头静脉 |
| 英文关键词:Ultrasonography Hemodialysis Internal arteriovenous fistula Radial artery Cephalic vein |
| 基金项目: |
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| 中文摘要: |
| 目的 探讨超声观察我国慢性肾衰竭患者前臂内瘘血管的解剖学特征的价值。方法 回顾性分析437例拟行前臂内瘘术,且术前行超声检查的慢性肾衰竭患者的前臂血管超声检查结果。结果 相同血管左、右侧内径比较,男、女同静脉内径比较,各年龄段最粗头静脉内径比较,各年龄段最粗桡动脉内径比较,差异均无统计学意义(P均>0.05)。双前臂中最粗的一支头静脉≥1.6 mm、≥1.8 mm、≥2.0 mm、≥2.5 mm者分为343例(343/437,78.49%)、289例(289/437,66.13%)、229例(229/437,52.40%)和128例(128/437,29.29%);最粗的一支桡动脉≥1.6 mm、≥1.8 mm、≥2.0 mm者分为347例(347/437,79.41%)、270例(270/437,61.78%)和204例(204/437,46.68%)。头静脉≥2.0 mm且桡动脉≥2.0 mm者占32.49%;头静脉≥1.8 mm且桡动脉≥1.8 mm占46.22%;一支动脉≥1.6 mm且一支静脉≥1.8 mm占60.18% (263/437);一支动脉≥1.6 mm且一支静脉≥1.6 mm占70.48% (308/437)。头静脉前臂中段或中上段为2支主干者38例;一侧手臂腕部头静脉≥1.8 mm,但前臂中上段无主干(血液经由众多细小静脉回流)者2例。同侧手臂一支动脉内径≥1.6 mm的且一支静脉内径≥1.6 mm者拟吻合静脉距体表为(3.38±1.37)mm。结论 中国慢性肾衰竭患者前臂血管内径多低于欧美指南推荐标准,建议应建立适合我国国情的前臂人工内瘘通路术前血管内径推荐标准。 |
| 英文摘要: |
| Objective To investigate the application value of ultrasonograghy in dissection characteristics of forearm internal fistula-related chief blood vessels in patients with chronic renal failure in China. Methods Data of forearm vascular ultrasonography in 437 patients with chronic renal failure who intended to undergo a forearm internal fistula operation were retrospectively studied. Results In the same blood vessels, compared the right and left, compared male and female, there was no statistical differences; The most rough cephalic venous diameter and radial artery diameter of each group were compared, there was no statistical differences. The most rough cephalic venous diameter in the both forearms which was ≥1.6 mm, ≥1.8 mm, ≥2.0 mm and ≥2.5 mm were 343 cases (343/437, 78.49%), 289 cases (289/437, 66.13%), 229 cases (229/437, 52.40%) and 128 cases (128/437, 29.29%). The most rough radial artery diameter in the both forearms which was ≥1.6 mm, ≥1.8 mm and ≥2.0 mm were 347 cases (347/437, 79.41%), 270 cases (270/437, 61.78%) and 204 cases (204/437, 46.68%). The cephalic vein and radial artery in the arm of the best vascular condition with respective diameter ≥2.0 mm and ≥2.0 mm accounted for 32.49%, ≥1.8 mm and ≥1.8 mm accounted for 46.22%. An artery and a vein with diameter ≥1.6 mm and ≥1.8 mm respectively accounted for 60.18% (263/437), ≥1.6 mm and ≥1.6 mm respectively accounted for 70.48% (308/437). Two venous trunks were present in the medio-superior part of the forearm in which the cephalic vein was ≥1.6 mm in 38 cases, and the cephalic vein in the wrist was ≤1.8mm, but no venous trunks existed in the mediosuperior part of the forearm in 2 cases. The anastomotic vein was about (3.38±1.37)mm apart from his body surface. Conclusion The internal diameter of the forearm blood vessels in the majority of Chinese patients with chronic renal failure is under the criteria recommended in the Western pertinent guidebooks. China should establish the forearm artificial fistula pathways within preoperative blood vessel diameter recommendation standard which is suitable for the situation of our country. |
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