科研之友
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摘要
background: when a hemodialysis arteriovenous fistula (havf) is created, it is important to wait for venous dilatation and volume flow increase through the havf, a phenomenon called maturation. there is still some controversy as to the exact time required for this maturation to occur. objective: to evaluate the time required for havf maturation using ultrasound criteria. method: from may 2004 through may 2005, 40 patients were prospectively selected. the sample was comprised of 23 men (57.5 %), mean age of 51.3㊣17.5 years, with indication of havf creation. logic iiiˋ ultrasound with 10 mhz transducer probe was used for pre- and postoperative evaluation 7, 14, 21 and 28 days after the procedure. criteria for maturation after the procedure were vein diameter larger than 4 mm and volume flow larger than 400 ml/min. results: preoperative mean diameter was 3.24㊣1.43 and 3.71㊣1.37 mm for fist and elbow fistula, respectively. final diameter of the fist havf was 5.01㊣0.87 mm (p = 0.006) and 6.15㊣1.16 mm for the elbow havf (p = 0.95). flow volume in the 7th postoperative day was 493.63㊣257.49 and 976.33㊣332.90 ml/min, respectively, for the fist and elbow havf. at the end of the study, the value of 556.81㊣288.42 ml/min was calculated for the fist havf (p %26lt; 0.05) and 1,031.62㊣614.812 ml/min for the elbow havf. based on both cut-off values, maturation occurred in 57.1% of the fist fistula and in 100% of the elbow fistula after the first week. after 4 weeks, 67.9% of the fist havf and 100% of the elbow havf presented maturation. conclusion: most elbow havf showed adequate diameter and flow volume for puncture 1 week after the procedure. for the fist fistula, gradual maturation occurred throughout the weeks, suggesting that these havf should be punctured 4 weeks after the surgery.
