CAJ | 학술논문

目的探讨自体动静脉内瘘局部血流动力学特点及其影响因素。方法选择维持性血液透析(maintennance hemodialysis,MHD)患者71例,横断面分析,应用彩超测量自体动静脉内瘘瘘口直径,双侧上肢桡动脉、尺动脉、肱动脉内径及血流量,分析动静脉内瘘对双侧上肢局部血流动力学的影响。结果动静脉内瘘手术后1~144个月,术侧头静脉内径(6.67±2.18)mm；术侧肱动脉内径(5.59±1.24)mm,对侧肱动脉内径(3.81±0.72)mm；术侧桡动脉吻合口近心端内径(4.12±1.13) mm,吻合口远心端(2.84±0.90)mm,对侧桡动脉内径(1.93±0.46)mm；术侧尺动脉内径(2.21±0.86)mm,对侧尺动脉内径(1.64±0.58)mm；术侧和对侧相比,有统计学差异(P<0.01)。术侧肱动脉血流量(2164.18±1413.06)ml/min,对侧肱动脉血流量(538.90±326.90)ml/min；术侧桡动脉血流量(1172.75±718.20)ml/min,对侧桡动脉血流量(106.50±75.83)ml/min；术侧尺动脉血流量(245.95±184.09)ml/min,对侧尺动脉近心端血流量(81.34±68.80)ml/min；术侧和对侧相比,有统计学差异(P<0.01)。结论自体动静脉内瘘建立后,术侧肢体的肱动脉、尺动脉、桡动脉内径相应增粗,血流量增大。
목적탐토자체동정맥내루국부혈류동역학특점급기영향인소。방법선택유지성혈액투석(maintennance hemodialysis,MHD)환자71례,횡단면분석,응용채초측량자체동정맥내루루구직경,쌍측상지뇨동맥、척동맥、굉동맥내경급혈류량,분석동정맥내루대쌍측상지국부혈류동역학적영향。결과동정맥내루수술후1~144개월,술측두정맥내경(6.67±2.18)mm；술측굉동맥내경(5.59±1.24)mm,대측굉동맥내경(3.81±0.72)mm；술측뇨동맥문합구근심단내경(4.12±1.13) mm,문합구원심단(2.84±0.90)mm,대측뇨동맥내경(1.93±0.46)mm；술측척동맥내경(2.21±0.86)mm,대측척동맥내경(1.64±0.58)mm；술측화대측상비,유통계학차이(P<0.01)。술측굉동맥혈류량(2164.18±1413.06)ml/min,대측굉동맥혈류량(538.90±326.90)ml/min；술측뇨동맥혈류량(1172.75±718.20)ml/min,대측뇨동맥혈류량(106.50±75.83)ml/min；술측척동맥혈류량(245.95±184.09)ml/min,대측척동맥근심단혈류량(81.34±68.80)ml/min；술측화대측상비,유통계학차이(P<0.01)。결론자체동정맥내루건립후,술측지체적굉동맥、척동맥、뇨동맥내경상응증조,혈류량증대。
Objective Toinvestigatethelocalhemodynamicsandinfluencingfactorsofautolo-gousarteriovenousfistula.Methods Seventy-onepatientswithmaintenancehemodialysis(MHD) were chosen in the cross-section analysis.Color Doppler ultrasound was applied to measure the diame-ter of autologous arteriovenous fistula,the inner diameter of radial artery,ulnar artery and brachial ar-tery.The influence of arteriovenous fistula on the local hemodynamics of bilateral upper extremity was analyzed.Results Fromthe1stto144thmonthafterarteriovenousfistulasurgery,theinnerdiameter of cephalic vein on the operated side was (6.67±2.18)mm;The inner diameter of brachial artery on the operated side was (5.59±1.24)mm,and that on the opposite side was (3.81±0.72)mm;The in-ner diameter of radial artery close to heart on the operated side was (4.12±1.13)mm,that of its dis-tal end was (2.84±0.90)mm,and that on the opposite side was (1.93±0.46)mm;The inner diame-ter of ulnar artery on the operated side was (2.21±0.86)mm,and that on the opposite side was (1.64 ±0.58)mm.The comparsion between the operated side and the opposite side(P<0.01),showed sig-nificant difference.The blood flow of brachial artery on the operated side was (2 164.18±1 413.06) ml/min,and that on the opposite side was (538.90±326.90)ml/min;The blood flow of radial artery on the operated side was (1 172.75±718.20)ml/min,and that on the opposite side was (106.50± 75.83)ml/min;The blood flow of ulnar artery on the operated side was (245.95±184.09)ml/min, and that on the opposite side was (81.34±68.80)ml/min.The comparsion between the operated side andtheoppositeside,P<0.01,showedsignificantdifference.Conclusions Afterarteriovenousfistu-la surgery,the inner diameter of brachial artery,ulnar artery and radial artery on the operated side is accordingly thinken,and the blood flow is increased.