Study on hemodynamic changes of autologous arteriovenous fistula in patients with diabetic nephropathy

doi:10.3969/j.issn.1009-6493.2017.13.012

Abstract：Objective:To explore the hemodynamic changes of autologous arteriovenous fistula in patients with or without diabetic nephropathy.Methods:A cross-sectional survey research design was used in this study.A total of 139 patients with maintenance hemodialysis who underwent autologous arteriovenous fistula as vessel access received color Doppler ultrasonic inspection from July to August in 2016.The two-dimensional ultrasound model was used to probe the vascular diameter and subcutaneous depth at 1 cm from fistula proximal anastomosis radial artery,1 cm,5 cm,and 10 cm from anastomotic venous to the anastomotic stoma.The blood vessel in puncture site had stenosis or occlusion or not at the same time.Results:The diameter of the anastomotic stoma,proximal anastomosis artery,at 1 cm and 5 cm from anastomotic vein to the anastomotic stoma and the blood flow of proximal anastomosis artery were significantly lower than those in the non-diabetic group,and the difference was statistically significant (P<0.05).The diameter of proximal anastomosis artery in patients with different genders in diabetic group was lower than that in non-diabetic group (P<0.05 or P<0.01).The diameter of the anastomotic stoma and the proximal anastomosis artery in patients with rope ladder puncture in the diabetic group were significantly smaller than those in the non-diabetic group (P<0.05 or P<0.01).The diameter of the anastomotic stoma and the proximal anastomosis artery in patients over 65 years old in the diabetic group were smaller than those in non-diabetic group (P<0.05 or P<0.01).Conclusion:There were differences in hemodynamic aspect of the autologous arteriovenous fistula between patients with or without diabetic nephropathy.In the vascular access maintenance and monitoring,medical staff should strengthen the monitoring of diameter of the anastomotic stoma and the proximal anastomosis artery and hemodynamic changes in patients with diabetic nephropathy,pay more attention to the vascular diameter in puncture site and the degree of stenosis,especially for hemodialysis patients with buttonhole puncture.