ABSTRACT
Objective To study the success experience of native arteriovenous fistula (AVF) operation,and provide a new reference range of blood vessel diameter for evaluating the success rate of AVF operation before surgery.Methods To proceed AVF operation to patients with 5 phase of chronic kidney disease,before surgery,patients should receive the vascular ultrasound and cardiac ultrasound to record the diameter of radio artery and cephalic vein along with the radio artery blood flow.Patients were divided into two groups:observation group(cephalic vein diameter< 2 mm)and control group(cephalic vein diameter > 2.0 mm). All those indexes examined before were re-examined 1 month after surgery. Except vessel diameter, the AVF blood flow velocity was also recorded. The range of the mature period was measured, along with the blood flow of each AVF 1 month after its initial use. The blood vessel diameter before surgery,the mature period of AVF and the blood flow on the machine of dialysis 1 month after the initial use were measured to evaluate the operation results of each group. Results In the observation group, 23 of the 25 patients showed the optimistic results. Unfortunately, 1 of the 2 pessimistic results showed the absence of vascular murmur,and the other one died of natural death before its initial use.The mature period of AVF for hemodialysis was(47.29 ± 2.45)d,significantly longer than that of control group (36.00 ± 1.29) d, and there was statistical difference (P<0.01). The blood flow of observation group showed no significant difference compared to that of control group (P > 0.05). Conclusions The patients with cephalic vein diameter<2.0 mm before operation needs a long mature period,but the blood flow after dialysis is not affected,and a good success rate is obtained.
ABSTRACT
Objective We observed influence of different handgrip exercise on the changes of blood flow velocity and blood vessel diameter of basilic vein before and after the PICC placement and discuss the best model for handgrip exercise.Methods 60 patients with PICC were chosen and divided into group A,B and C with 20 patients in each groups.Group A received routine guidance on unarmed handgrip exercise,group B used electronic handgrip,the frequency was 25 times/min,the time period was 2 min with 4 times a day,once every 4 hours,group C adopted the same model as that of group B and 6 times a day,once every 3 hours.The venous blood flow velocity and blood vessel diameter was measured by pulsed Doppler ultrasound one hour before the PICC placement and one hour,1 day,3 days,7 days,10 days,14 days,21 days after placement.Results The venous blood flow velocity before and after PICC placement had statistically significant differences at different time points (F=2.934,P ＜ 0.05).The effect of group B and C was better than that of the group A and group C showed the best effect.The blood vessel diameter before and after PICC placement had significant differences at different time points(F=3.940,P ＜ 0.05).There was significant differences in the blood vessel diameter 1h before and 1h after PICC placement.Conclusions Handgrip exercise can effectively promote the upper limb venous blood flow velocity in patients with PICC,but shows little effect on the blood vessel diameter.Using the electronic hand grip in weak tap position,25 times/min,2 min every time,and 6 times a day (once every 3 hours),can obviously promote the upper limb venous blood flow velocity.