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首页> 中文期刊> 《浙江临床医学》 >彩色多普勒超声诊断慢性肾脏病血液透析患者中心静脉狭窄及闭塞的价值

彩色多普勒超声诊断慢性肾脏病血液透析患者中心静脉狭窄及闭塞的价值

         
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目的 探讨彩色多普勒超声在慢性肾脏病血液透析患者中心静脉狭窄及闭塞诊断中的应用价值.方法 选择2016年2月至2018年2月疑似中心静脉病变的慢性肾脏病血液透析患者32例,回顾分析患者的彩色多普勒超声检查及血管静脉造影检查结果,评估彩色多普勒超声检查对中心静脉狭窄和闭塞的诊断价值.结果 32例患者经静脉血管造影检查显示中心静脉完全闭塞10例,中心静脉狭窄17例,静脉血管无明显异常5例;经彩色多普勒超声检查显示中心静脉完全闭塞11例,中心静脉狭窄13例,静脉血管无明显异常8例,与静脉血管造影检查结果一致率90.63%.彩色多普勒超声血流量评估中心静脉狭窄及闭塞的ROC曲线下面积为0.927,约登指数为0.823,灵敏度90.00%,特异度92.31%.结论 彩色多普勒超声检查在慢性肾脏病血透患者中心静脉狭窄及闭塞评估中具有较高有效性,但对部分静脉狭窄仍存在漏诊现象.%Objective To?evaluate?the?value?of?color?doppler?ultrasound?in?the?diagnosis?of?central?venous?stenosis?and?occlusion?in?hemodialysis?patients?with?chronic?kidney?disease.?Methods 32?cases?of?hemodialysis?patients?with?suspected?central?venous?lesions?with?chronic?kidney?disease?were?enrolled?in?this?study?from?February?2016?to?February?2018.?The?images?of?color?Doppler?ultrasonography?and?angiographic?imaging?of?all?the?patients?were?analyzed,and?the?value?of?color?Doppler?ultrasonography?in?the?diagnosis?of?central?venous?stenosis?and?occlusion?were?evaluated.?Results The?venous?angiography?in?32?patients?showed?10?cases?of?central?venous?occlusion,17?cases?of?central?venous?stenosis,no?obvious?abnormalities?in?5?cases.?Color?Doppler?ultrasonography?showed?central?venous?occlusion?in?11?cases,central?venous?stenosis?in?13?cases,no?obvious?abnormalities?in?8?cases,the?coincidence?rate?with?venous?angiography?was?90.63%(29/32).?The?under?the?ROC?curve?area?of?blood?flow?was?0.927?in?the?diagnosis?of?central?venous?stenosis?and?occlusion,and?the?Gordon?index?was?0.823.?The?sensitivity?and?specificity?of?ultrasound?diagnosis?of?venous?stenosis?and?occlusion?were?90.00%?and?92.31%.?Conclusion Color?Doppler?ultrasonography?is?effective?in?the?assessment?of?central?venous?stenosis?and?occlusion?in?hemodialysis?patients?with?chronic?kidney?disease,but?there?is?still?a?misdiagnosis?of?some?venous?stenosis.

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