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| 左室收缩功能对自体动静脉内瘘吻合术后头静脉内径及血流量的影响 |
| Effect of left ventricular systolic function on internal diameter and blood flow of cephalic vein after autologous arteriovenous fistula anastomosis |
| 投稿时间：2018-08-09 |
| DOI：10.3969/j.issn.1000-0399.2019.02.006 |
| 中文关键词: 左室收缩功能 自体动静脉内瘘 头静脉 血流量 |
| 英文关键词: Left ventricular systolic function Autologous arteriovenous fistula Cephalic vein Blood flow |
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| 中文摘要: |
| 目的 探讨手术前左室收缩功能对自体动静脉内瘘（AVF）吻合术后头静脉内径及血流量的影响。方法 选择2015年6月至2016年12月中国人民解放军第一零五医院收治并拟建立AVF的终末期肾脏病（ESRD）患者54例，根据术前左室射血分数（LVEF）将54例患者分为LVEF正常组33例（LVEF >50%）和LVEF降低组21例（LVEF ≤ 50%）。采用彩色多普勒超声测量两组患者术前头静脉内径及术后2周、4周、6周、8周头静脉内径和血流量，比较两组患者头静脉内径及血流量的差异，采用Pearson相关分析术前LVEF与术后头静脉内径和血流量变化值的相关性。结果 两组患者术后2~8周内头静脉内径及血流量均逐渐增加，差异有统计学意义（P<0.05）。LVEF正常组术后4周、6周、8周头静脉内径均大于LVEF降低组，差异均有统计学意义（P<0.05），LVEF正常组术后6周、8周头静脉血流量均大于LVEF降低组，差异有统计学意义（P<0.05）。Pearson相关性分析显示，术前LVEF与术后2~4周、4~6周及6~8周头静脉内径变化值成正相关（r=0.270、0.305、0.308；P均<0.05），术前LVEF与术后4~6周及6~8周头静脉血流量变化值成正相关（r=0.318、0.299；P均<0.05）。结论 AVF吻合术前LVEF影响术后头静脉内径及血流量的变化，高LVEF有利于术后头静脉的扩张及血流量的增加。 |
| 英文摘要: |
| Objective To explore the effect of preoperative left ventricular systolic function on the internal diameter and blood flow of the cephalic vein after autologous arteriovenous fistula anastomosis. Methods We selected 54 patients with end-stage renal disease (ESRD) who were admitted to the 105th Hospital of PLA from June 2015 to December 2016 and planned to establish AVF. According to the preoperative left ventricular ejection fraction (LVEF), 54 patients were divided into LVEF normal group (33cases, LVEF >50%) and LVEF decrease group (21cases, LVEF ≤ 50%). The internal diameter of cephalic vein was measured before the operation by color Doppler ultrasound. The internal diameter and blood flow of the cephalic vein were measured by color Doppler ultrasound 2 weeks, 4 weeks, 6 weeks and 8 weeks after the operation. The internal diameter and blood flow of the cephalic vein were compared among the two groups at different periods after the operation. The correlation between preoperative LVEF and the changes of cephalic vein diameter and blood flow after operation were analyzed by Pearson correlation analysis. Results The overall comparison showed internal diameter of the cephalic vein and blood flow increased gradually 2~8 weeks after the operation (P<0.05). The internal diameter of the cephalic vein in LVEF normal group was larger than that of LVEF decrease group 4weeks, 6 weeks and 8 weeks after the operation (P<0.05). The blood flow in LVEF normal group was higher than that of LVEF decrease group 6 weeks and 8 weeks after the operation (P<0.05). Pearson correlation analysis showed that preoperative LVEF was positively correlated with the changes of the diameter of cephalic vein diameter during 2~4 weeks, 4~6 weeks,6~8 weeks (r=0.270、0.305、0.308, P<0.05) and the changes of blood flow at 4~6 weeks and 6~8 weeks after operation (r=0.318、0.299, P<0.05). Conclusion LVEF before AVF anastomosis affects the internal diameter and blood flow of the cephalic vein. High LVEF is conducive to the expansion of the cephalic vein and blood flow increase after AVF anastomosis. |
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