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題名 | Predicting the Outcome of Hemodialysis Arteriovenous Fistulae using Duplex Ultrasonography=以複合都卜勒超音波檢查預測血液透析瘻管的預後 |
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作者 | 林水龍; 陳煥升; 黃靖惠; 嚴澯鑫; Lin, Shuei-liong; Chen, Huan-sheng; Huang, Ching-huai; Yen, Tsan-shin; |
期刊 | 臺灣醫學會雜誌 |
出版日期 | 19971100 |
卷期 | 96:11 1997.11[民86.11] |
頁次 | 頁864-868 |
分類號 | 415.816 |
語文 | eng |
關鍵詞 | 複合都卜勒超音波檢查; 血液透析; 瘻管; Duplex ultrasonography; Primary arteriovenous fistula; Blood flow; |
英文摘要 | Duplex ultrasonography is a reliable method for assessing the anatomic features and blood flow rate of a vascular access point of hemodialysis. We assessed the value of measurement of cross-sectional area and blood flow rate of the major outflow veins using duplex ultrasonography in predicting the outcome of fistulae. Radiocephalic arteriovenous fistulae were created in 126 consecutive end-stage renal failure patients (55 men, 71 women; aged 20-83 yr) and examined using duplex ultrasonography in the second week following surgery. Examinations were repeated in 45 of the 126 fistulae in the third week. The outcome of new fistulae was classified as success or failure. The failure group fistulae were further classified as delayed maturation or primary failure. The cross-sectional area (12.1±3.5 vs 6.9±2.4 mm□) and blood flow rate (825.6±424.3 vs 303.7±114.5mL/min) were significantly lower in the failure group. but there was no difference between the subgroups of primary failure and delayed maturation. Receiver- operating characteristic plots were generated for cross-sectional area and blood flow rate. The best cut-off point for distinguishing successful outcome form failure was 8.5mm□ for cross-sectional area (sensitivity 0. 823, specificity 0.867, positive predictive value 0.952, negative predictive value 0.605) and 425 mL/min for blood flow rate (sensitivity 0.813 , specificity 0.933, positive predictive value 0.975, negative predictive value 0.609). Our findings show the cross-sectional area and blood flow rate, as measured using duplex ultrasonography, are useful in predicting the outcome of vascular access points of hemodialysis. |
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