The Clinical Value Of Color Doppler Ultrasound On Postoperative Autologous Radio-Cephalic Fistula

Objective to observe the internal diameter and blood flow of cephalic vein、the complications by color Doppler ultrasound technique after the construction of wrist arteriovenous fistula( AVF), and evaluate the function of AVF. At the same time,this study was designed to explore the risk factors AVF dysfunction to improve the function of AVF.Methods A total of 88 patients who in the Fujian First Affiliated Hospital were enrolled from January 2013 to January 2016 were retrospectively analyzed.It is the first time of these patients to have the construction of wrist arteriovenous fistula. And all of them done follow-up ultrasound regularly. Among them,51 patients were male and 37 patients were female with ages of( 62.1 ± 14.5) years.Measure the internal diameters and blood flow rate of cephalic vein by color Doppler ultrasound technique on the 1st、the day after 1st month、the day 2nd month after surgery of 71 patients whose AVF is useful.And measure the blood flow through the blood flow rate on the 1st、after the day 1st month、the day 2nd month after surgery. The blood flow of cephalic vein(ml/min)=(the diameter2(cm2) ×π/4×blood flow of cephalic vein(ml/s)×60). Subdivided the cephalic vein and blood flow into three age groups depend on the follow-up time: the 1st、the day after 1st month、the day 2nd month. The measures analyzed with the paired t-test to investigate the growth of the cephalic vein and blood flow. At the same time,observe the complications after the construction of wrist arteriovenous fistula( AVF). Patients were subdivided into two age groups: 32 patients were Group 1:(≤60 years);56 patients were Group 2:( >60 years).. The fistula complications performed the observation. Theχ2 test was conducted.COX regression was used to compare the risk factors of AVFs. Kaplan-Meier analysis was used to compare the survival cure of patients in different groups.Results: 71 patients were followed up for 2 month and the function of autologous AVF reached the standard of hemodialysis except the17 failures. There were 8 patients who suffered complications after surgery in Group 1,but 19 in Group 2. The difference of complications after surgery was not statistically significant( P>0. 05).COX regression shows the risk factors associated with prognosis were diabetes(P=0.023,RR=127.727) 、smoking(P=0.002,RR=7.227).Kaplan-Meier analysis show that the survival rate of G1(95%CI: 30.463-35.692) is better than G2(95%CI: 23.678-31.141,P=0.044<0.05).Conclusions The color Doppler ultrasound technique plays an important role in evaluating the situation after the construction of wrist arteriovenous fistula( AVF).it can find the failures and complications in times after the surgery to help clinical doctors to treat it. DM and smoking are the risk factors of AVF. And the AVF is associated with the ages.