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目的分析肾功能衰竭(RF)患者动-静脉造瘘术后出现血液透析灌注不足的超声图像特征。方法彩色多普勒超声观察65例造瘘术后血液透析灌注不足RF患者头静脉、桡动脉及吻合口的内径、走形、彩色血流束及血流动力学参数,计算狭窄血管的狭窄度。结果 46例(70.77%)血栓形成;其中,完全闭塞16例,狭窄30例。14例(21.54%)吻合口瘢痕收缩;其中,高度狭窄8例,中度狭窄6例。2例(3.08%)吻合口手术狭窄,均为中度狭窄。3例(4.62%)局部血肿压迫;其中,1例闭塞,2例中度狭窄。结论血栓形成、吻合口瘢痕收缩、吻合口手术狭窄及局部血肿压迫是RF患者造瘘术后血液透析灌注不足的主要原因;血管闭塞及狭窄是造成灌注不足的血流动力学原因。
Objective To analyze the ultrasonographic features of hemodialysis perfusion after arteriovenous ostomy in patients with renal failure (RF). Methods Color Doppler ultrasound was used to observe the diameter, shape, color flow and hemodynamics parameters of the head vein, radial artery and anastomosis in 65 patients with hemodialysis insufficiency after ostomy. The stenosis of stenosis was calculated . Results 46 cases (70.77%) thrombosis; of which 16 cases were completely occluded and 30 cases were stenosis. Fourteen cases (21.54%) had anastomotic scar shrinkage. Among them, 8 cases were highly stenosis and 6 cases were moderate stenosis. 2 cases (3.08%) anastomotic stenosis, were moderate stenosis. Three cases (4.62%) of local hematoma oppression; of which 1 case occlusion, 2 cases of moderate stenosis. Conclusion Thrombosis, anastomotic scar contraction, stenosis of anastomosis and local hematoma compression are the main causes of hemodialysis perfusion after ostomy in patients with RF. Vascular occlusion and stenosis are the causes of hypoperfusion.