中华实验外科杂志
中華實驗外科雜誌
중화실험외과잡지
CHINESE JOURNAL OF EXPERIMENTAL SURGERY
2015年
5期
1184-1186
,共3页
血液透析%动静脉内瘘%瘘口直径%血压%心功能
血液透析%動靜脈內瘺%瘺口直徑%血壓%心功能
혈액투석%동정맥내루%루구직경%혈압%심공능
Hemodialysis%Arteriovenous fistula%Fistula diameter%Blood pressure%Heart function
目的 观察血液透析患者自体动静脉内瘘(AVF)瘘口直径对血压和心脏功能的影响.方法 以60例接受AVF制作的血液透析患者为研究对象,根据术后彩色多普勒超声所测得的瘘口直径(AVFD),将患者分为A组20例(直径2.1～3.0 mm);B组20例(直径3.1～4.0 mm);C组20例(直径4.1～5.0 mm).每组患者手术前、术后行心脏彩色多普勒超声检查,观察并严格记录血压(BP)、心率(HR)、心排出量(CO)、心脏指数(CI)、射血分数(EF)、动静脉内瘘血流量(AVFB),分析3组不同AVFD对血液透析患者血压和心脏功能的影响及相关性.结果 3组患者AVF术前CO为(4.80 ±0.35) L/min,术后为(5.54±0.86) L/min;术前CI为(2.70 ±0.17) L/(min·m2),术后为(7.20 ±0.52) L/(min·m2),术前EF为(55.5 ±1.9)％,术后为(58.4±3.9)％,即CO、CI、EF术后较术前增加(P ＜0.05或P＜0.01).3组患者的AVFB、AVFD与CO差值(ΔCO)、CI差值(ΔCI)呈正相关(r =0.516,P＜0.05).A、B、C3组AVFB、ΔCO、ΔCI随AVFD增大而递增,且相互间差异有统计学意义(P＜0.05).结论 血液透析患者AVF瘘口直径大小与血压、心脏功能的变化密切相关,适当的瘘口直径对于减小AVF对血压和心功能的影响,以保持AVF血沆长期通畅至关重要.
目的 觀察血液透析患者自體動靜脈內瘺(AVF)瘺口直徑對血壓和心髒功能的影響.方法 以60例接受AVF製作的血液透析患者為研究對象,根據術後綵色多普勒超聲所測得的瘺口直徑(AVFD),將患者分為A組20例(直徑2.1～3.0 mm);B組20例(直徑3.1～4.0 mm);C組20例(直徑4.1～5.0 mm).每組患者手術前、術後行心髒綵色多普勒超聲檢查,觀察併嚴格記錄血壓(BP)、心率(HR)、心排齣量(CO)、心髒指數(CI)、射血分數(EF)、動靜脈內瘺血流量(AVFB),分析3組不同AVFD對血液透析患者血壓和心髒功能的影響及相關性.結果 3組患者AVF術前CO為(4.80 ±0.35) L/min,術後為(5.54±0.86) L/min;術前CI為(2.70 ±0.17) L/(min·m2),術後為(7.20 ±0.52) L/(min·m2),術前EF為(55.5 ±1.9)％,術後為(58.4±3.9)％,即CO、CI、EF術後較術前增加(P ＜0.05或P＜0.01).3組患者的AVFB、AVFD與CO差值(ΔCO)、CI差值(ΔCI)呈正相關(r =0.516,P＜0.05).A、B、C3組AVFB、ΔCO、ΔCI隨AVFD增大而遞增,且相互間差異有統計學意義(P＜0.05).結論 血液透析患者AVF瘺口直徑大小與血壓、心髒功能的變化密切相關,適噹的瘺口直徑對于減小AVF對血壓和心功能的影響,以保持AVF血沆長期通暢至關重要.
목적 관찰혈액투석환자자체동정맥내루(AVF)루구직경대혈압화심장공능적영향.방법 이60례접수AVF제작적혈액투석환자위연구대상,근거술후채색다보륵초성소측득적루구직경(AVFD),장환자분위A조20례(직경2.1～3.0 mm);B조20례(직경3.1～4.0 mm);C조20례(직경4.1～5.0 mm).매조환자수술전、술후행심장채색다보륵초성검사,관찰병엄격기록혈압(BP)、심솔(HR)、심배출량(CO)、심장지수(CI)、사혈분수(EF)、동정맥내루혈류량(AVFB),분석3조불동AVFD대혈액투석환자혈압화심장공능적영향급상관성.결과 3조환자AVF술전CO위(4.80 ±0.35) L/min,술후위(5.54±0.86) L/min;술전CI위(2.70 ±0.17) L/(min·m2),술후위(7.20 ±0.52) L/(min·m2),술전EF위(55.5 ±1.9)％,술후위(58.4±3.9)％,즉CO、CI、EF술후교술전증가(P ＜0.05혹P＜0.01).3조환자적AVFB、AVFD여CO차치(ΔCO)、CI차치(ΔCI)정정상관(r =0.516,P＜0.05).A、B、C3조AVFB、ΔCO、ΔCI수AVFD증대이체증,차상호간차이유통계학의의(P＜0.05).결론 혈액투석환자AVF루구직경대소여혈압、심장공능적변화밀절상관,괄당적루구직경대우감소AVF대혈압화심공능적영향,이보지AVF혈항장기통창지관중요.
Objective To investigate the autogenous arteriovenous fistula in patients of hemodialysis (AVF) effect of diameter on blood pressure and heart function and correlation.Methods 60 patients received AVF production in hemodialysis patients as the research object,according to the postoperative color Doppler ultrasound measured diameter (AVFD),the patients were divided into A group of 20 cases (diameter of 2.1-3.0 mm);B group of 20 cases (diameter 3.1-4.0 mm);20 cases in group C (diameter of 4.1-5.0 mm).Surgical patients before and after heart color Doppler ultrasound,observed and strictly record blood pressure (BP),heart rate (HR),cardiac output (CO),cardiac index (CI),ejection fraction (EF),arteriovenous fistula blood flow (AVFB),analysis of 3 different effects of AVFD on the blood pressure and heart function in patients with hemodialysis and correlation.Results 3 groups of patients with AVF after BP,HR,CO,CI,EF values increased compared with the preoperative (P ＜ 0.05 or P ＜ 0.01).3 groups of patients with AVFB,AVFD and CO difference (ΔCO),CI difference (Δ CI) had a positive linear correlation (r =0.518,P ＜ 0.05).A,B,C and 3 in group AVFB,Δ CO,Δ CI as AVFD increases,and ask each significant differences (P ＜ 0.05).Conclusion The changes of AVF in hemodialysis patients fistula orifice diameter and blood pressure,cardiac function is closely related to the appropriate diameter of the fistula orifice for reducing the effect of AVF on blood pressure and cardiac function,to maintain long-term patency crucial AVF flow.
