关键词: 糖尿病肾病, 动静脉内瘘, 成熟度, 血流动力学, 彩色多普勒超声

Abstract: 【Abstract】Objective To study the difference of the maturation of autologous arteriovenous fistula (AVF) between the patients with type 2 diabetic nephropathy and those with non-diabetic nephropathy, and to provide suggestions for dialysis treatment and nursing in these patients. Methods Sixty patients with diabetic nephropathy and treated in the period from January 2017 to July 2019 were recruited as the observation group, and 60 patients with non-diabetic nephropathy in the same period were randomly selected as the control group. Maturation of AVF and hemodynamic parameters of the patients in the two groups were examined by physical examination and color Doppler ultrasound and then analyzed retrospectively. Results ①In observation
group, the average maturation period of AVFs was 88.25±7.30 days, the average internal diameter of cephalic vein was 4.85±1.31 mm, and the average blood flow was 586.49±78.33 ml/min, significantly different from those in control group (t=-20.591, P<0.001 for maturation period; t=3.385, P=0.001 for cephalic vein diameter; t=4.667, P<0.001 for blood flow). ②in observation group, the diameter of radial artery was smaller than that in control group before the surgery (t=2.224, P= 0.029), and remained smaller after maturation (t=-3.134, P=0.002). The periods of internal diameter of cephalic vein and blood flow rate to the maturation values were 2 and 4 weeks in control group and observation group respectively. Conclusion The maturation and hemodynamics of AVF after the surgery are different between patients with diabetic nephropathy and those with non-diabetic nephropathy. These differences are of great significance in accurate determination of the AVF maturity, the time suitable for blood access, and successful performance of hemodialysis.

Key words: Diabetic nephropathy, Arteriovenous fistula, Maturity, Hemodynamics, Color Doppler ultrasonography