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成熟血液透析动静脉内瘘的临床检查与监测

Author
Michael Allon, MD
Section Editors
Jeffrey S Berns, MD
John F Eidt, MD
Joseph L Mills, Sr, MD
Deputy Editors
Alice M Sheridan, MD
Kathryn A Collins, MD, PhD, FACS
Translators
龚德华, 主任医师，教授

引言

动静脉内瘘(arteriovenous fistulas, AVF)能够提供血液透析所需的快速体外循环血流，但由于AVF常存在血管狭窄，如未及时发现和治疗，可导致血液透析不充分或内瘘血栓形成。

本专题将总结血液透析AVF的检查与监测相关问题。有关血液透析动静脉(arteriovenous, AV)移植血管的类似问题将单独讨论。 (参见“防止血液透析动静脉移植物血栓形成的检查与监测”)

AV内瘘检查和监测的基本原理

几乎所有形成血栓的成熟内瘘都有潜在狭窄性病变。一项病例系列研究显示了这一点，该研究中93例连续性血栓形成内瘘中100%有潜在的血管狭窄[1]。 (参见“成熟的血液透析动静脉瘘失功”)

尽管血管造影是发现和明确血管病变特征的敏感性及特异性最高的影像学方式，但其花费较高而且有创[2-6]。作为筛查目的，在首次检查狭窄可能性较高的内瘘时采用无创性评估方法更好。筛查试验显示有明显异常的AVF，再行诊断性血管造影，并在需要时治疗。目前临床检查与监测已用于筛查血管狭窄性病变。

●临床检查(参见下文‘临床检查’)

             

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Literature review current through: 2017-06 . | This topic last updated: 2017-05-12.
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