Application Of Cardiovascular Ultrasound In Evaluating Patients With End-stage Renal Failure Before Dialysis

Objective:To elucidate the influence of preoperative color Doppler ultrasound on surgical decision and prognosis of end-stage renal failure patients before dialysis.New ultrasound indicators will be introduced into the pre-dialysis examination program to help clinicians and patients determine dialysis access to reduce the incidence of poor prognosis in dialysis patients.Through health education,it provides practical basis for clinical promotion of optimal preoperative examination of dialysis patients.Methods:By random sampling method,74 patients with end-stage renal disease from the Department of Nephrology of Sichuan Provincial People’s Hospital who planned to establish a dialysis access were included in the experiment.Color Doppler ultrasound data of the patients’ heart and upper limbs were collected before the operation by means of ultrasonic evaluation.The baseline data and disease history of the patients were also collected.Ultrasound results,clinical data and 8 weeks later follow-up results were collected for statistical analysis.Results:After the 8-week follow-up period,1 patient was lost to follow-up and 2 patients withdrew from the study due to their own reasons.A total of 71 patients were included in the statistics.According to the follow-up outcome,the patients were divided into "select internal fistula for dialysis group" and "not select internal fistula for dialysis group".1.There were significant differences in age,body mass index,mitral valve-e,internal diameter before and after pressure of the upper limb-cephalic veins,the ratio of internal diameter before and after pressure of the basilic vein of the superior arm and some segments of upper limb-cephalic veins,and the radial arterio-cephalic vein distance at the lower forearm between the two groups(p < 0.05).2.According to the logistic regression results,age,body mass index,internal diameter before and after pressure of cephalic vein in forearm,internal diameter of cephalic vein in upper arm,distance between radial artery and cephalic vein in lower forearm,ratio of internal diameter before and after pressure of cephalic vein in middle forearm had statistical significance(p < 0.05).3.Diabetes,heart disease,internal diameter of cephalic vein in each segment of the upper limb,internal diameter before and after pressure of cephalic vein in the lower and middle forearm,and internal diameter ratio before and after pressure of cephalic vein in the lower forearm can affect the surgical outcome of patients after internal fistula surgery(p < 0.05).Conclusion:1.Patients’ baseline data and preoperative cardiovascular ultrasound results can affect patients’ final surgical decision before the establishment of dialysis access,and affect the outcome of different patients.2.Before the establishment of dialysis access,age,BMI,left diastolic function,upper limb vein diameter,upper limb vein elasticity and other conditions played a major role in the clinical outcomes.3.In patients who choose internal fistula surgery,previous history of diabetes or heart disease,and internal diameter and elasticity of each segment of cephalic vein will affect the final surgical outcome of patients.