The Clinical Study Of Ultrasonic Examination In The Detection Of Arteriovenous Fistula Stenosis

The preferred pathway of hemodialysis in patients with end-stage renal disease is autogenous arteriovenous fistula(AVF).Complications of AVF seriously affect the service life of AVF and the patient’s quality of life,so the AVF monitoring is crucial,early detection,early intervention can significantly extend the time limit of AVF,improve the quality of life of the patients.Ultrasonography and physical examination are commonly used methods of examination,and studies have shown that ultrasonography plays an important role in the detection of arteriovenous fistula stenosis.Objective:The overall purpose of this study was to explore the ultrasound(US)in arteriovenous fistula narrow the important function of the evaluation,diagnosis and prognosis,and compare the physical examination(PE)and ultrasound(US)in the check arteriovenous fistula stenosis rate of accuracy.Methods:This is a cross-sectional study of 64 patients with routine hemodialysis in our hospital from October 2015 to March 2016.In the double blind,the physical examination and ultrasonic examination of 64 patients were performed by different ultrasound physicians in our hospital.The diameter,velocity and resistance index of the brachial artery,radial artery,anastomotic stoma and head vein of the patients with the stenosis group and non-stenosis group were compared and analyzed.Sensitivity,specificity,positive predictive value(PPV),negative predictive value(PNV),likelihood ratio(LR),and Kappa value of Cohen were measured for physical examination and examination results of individual signs.Results:According to the results of ultrasound examination,28 cases(43.8%)patients had a narrow,physical examination,there are 34 cases(53.1%)patients with stenosis,30(46.9%)patients had no narrow,34 patients with narrow integrated by ultrasound confirmed that there are 24 patients(70.6%)stenosis,30 cases of patients with narrow integrated by ultrasound confirmed presence of 4(13.3%)patients were narrow.In contrast with the results of ultrasonography,the sensitivity of physical examination was 86%,specificity 72%,PPV 71%,NPV87%,LR 3.09 and 0.20,respectively,in the diagnosis of AVF stenosis rate.There is a moderate consistency between physical examination and ultrasonic examination(k=0.57).Conclusion:Ultrasonography plays an important role in the assessment,diagnosis and prognosis of arteriovenous fistula.Physical examination,as a kind of auxiliary examination,helps to detect the complications of AVF in time and intervene in time to prolong the life of AVF and improve the quality of life.