Objective To discuss the value of vascular access flow dysfunction under the dialysis process by ultrasonic imaging.Methods One houndred and nine hemodialysis patients were found to appear inadequate vascular access flow which were checked with ultrasound,the aterial access inflow or the venous outflow proximal and distal,fistulae two-dimension,color flow imaging were mapped,the peak systolic velocity (PSV),the end diastolic velocity (EDV),the resistent index(RI) were measured respectively.Results Color Doppler imaging of the access dysfunction during hemodialysis,some are normal(group A) which the structure and function are normal,the other are abnormal,among those:26 ones for venous intmal with focal incrassation,18 ones for thrombosis,11 ones for venous with dilation,10 ones for venous with stonesis,2 ones for aneurysm ruputure with repair.Between Group A and group B,the color Doppler ultrasonic evaluation of the arteriovenous fistula:there is no statstics significance between the structure,statstics significance between vascular flow indexes.It is important for surveillance inadequate vascular access flow with ultrasound imaging to make thrombosis ratio decreases from 6.4％ to 3.8％,thrombolysis ratio increases from 29％ to 100％,opertion ratio decreases from 71％ to 25％.Conclusions Color imaging is an ideal noninvasive diagnostic modality for evaluation of native arteriovenous fistulae,which is superiority such as unharmful,reputably and exactly,it may be an aid for assessment of both anatomy and hemodynamics of an AVFquickly,and provide valuable informations for the next treatment.%目的 探讨超声检查血透患者自体动静脉内瘘功能不良的应用价值.方法 在透析过程中临床显示内瘘流量不良患者109例,采用高频彩超检查内瘘,扫查内瘘动脉流入道及静脉流出道近心端、远心端、瘘口二维、血流显像及血流频谱测量其收缩期峰值(PSV)、舒张期流速(EDV)、阻力指数(RI).结果 在109例内瘘流量不良的患者中,超声显示内瘘功能正常者42例(A组)(42/109),不良者67例,其中静脉侧内膜局限性增厚26例(B组),血栓形成18例,静脉瘤样扩张11例,静脉侧狭窄10例,动脉瘤破裂修补2例.A组和B组超声检查,其结构之间没有统计学意义,血流动力学指标(PSV、EDV及RI)之间有统计学意义(P＜0.05).经超声筛查,瘘的血栓发生率逐年从6.4％下降到3.8％,溶栓率逐年从29％上升到100％,手术率逐年从71％下降到25％.结论 彩超是评估血液透析自体动静脉内瘘的首要手段,它能快捷准确地评估血液透析自体动静脉内瘘的结构和功能情况,为进一步治疗提供可靠的参考.
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