上肢CT血管成像在动静脉瘘术后患者血管方面的评估价值分析
Evaluation value of upper extremity CT angiography in vascular evaluation of patients after arteriovenous fistula
梁万强 1尤云峰 1徐燕1
作者信息
- 1. 洛阳市东方人民医院医学影像科,河南 洛阳 471000
- 折叠
摘要
目的:分析上肢CT血管成像(CT angiography,CTA)于动静脉瘘术后患者血管方面中的应用价值.方法:选取我院 2019 年 1 月至 2022年 12 月期间收治的行动静脉瘘手术的血液透析患者 74 例作为研究对象.所有患者均行CTA检查.术后6 m,统计动静脉瘘功能不良发生率,对比不同动静脉瘘功能状况患者CTA参数.分析CTA参数对于动静脉瘘功能的影响;CTA 参数预测血液透析患者动静脉瘘功能不良价值.分析不同水平 CTA 参数的血液透析患者动静脉瘘功能不良的发生危险度.结果:动静脉瘘功能不良率为25.68%(19/74).功能不良者桡动脉处剪切力高于功能良好者,吻合口静脉端血流流速低于功能良好者(P＜0.05).桡动脉处剪切力＞35.22 dyne·cm-2、吻合口静脉端血流流速≤109.42 cm·s-1 为功能不良的危险因素(P＜0.05);吻合口静脉端血流流速、桡动脉处剪切力联合预测动静脉瘘功能不良的曲线下面积为0.830(P＜0.05).高水平吻合口静脉端血流流速、桡动脉处剪切力患者发生动静脉瘘功能不良的危险度为低水平0.281倍、3.049倍(P＜0.05).结论:CTA能呈现血液透析患者动静脉瘘处血管状况.
Abstract
Objective:To analyze the application value of upper extremity CT angiography(CTA)in the vascular aspects of patients after arteriovenous fistula.Methods:74 hemodialysis patients admitted to our hospital during mobile venous fistula surgery from January 2019 to December 2022 were selected as the study objects.All patients underwent CTA examination.The incidence of arteriovenous fistula dysfunction was analyzed.The CTA parameters of patients with different functional status of arteriovenous fistula were compared.The effects of CTA parameters on the function of arteriovenous fistula were analyzed.Value of CTA parameters in predicting arteriovenous fistula dysfunction in hemodialysis patients.The risk of arteriovenous fistula dysfunction in hemodialysis patients with different levels of CTA parameters was analyzed.Results:The dysfunctional rate of arteriovenous fistula was 25.68%(19/74).The shear force of the radial artery in the patients with poor function was higher than that in the patients with good function,and the blood flow velocity of the anastomotic vein was lower than that in the patients with good function(P<0.05).Shear force>35.22dyne/cm2 at radial artery and venous flow velocity≤109.42cm/s were the risk factors for poor function(P<0.05).The area under curve(AUC)of anastomotic venous flow velocity and radial shear force combined to predict arteriovenous fistula dysfunction was 0.830(P<0.05).The risk of arteriovenous fistula dysfunction in patients with high anastomotic venous flow velocity and radial shear force was 0.281 times and 3.049 times higher than that in patients with low anastomotic venous flow velocity(P<0.05).Conclusion:CTA can present the vascular status of arteriovenous fistula in hemodialysis patients.
关键词
CT血管成像/动静脉瘘/血液透析Key words
CT angiography/Arteriovenous fistula/Hemodialysis引用本文复制引用
出版年
2024
NETL
NSTL
万方数据