关键词: 尿毒症, 血液透析, 动静脉内瘘, 血栓

Abstract: Objective To investigate the application of arterioveneous fistula in hemodialysis patients and to find out the cause and management of fistula dysfunction. Methods We collected disease history and physical examinations from 436 patients. Arterioveneous fistula was built by side-to-side anastomosis between radial artery and cephalic vein and ligation of cephalic vein at the distal part to form an improved terminal-side anastomosis in the unaccustomed-used forearm. In a few patients fistula was set in the accustomed-used forearm. We recorded general condition of the fistula, onset of hemodialysis, time of the fistula surgery, use of the fistula and period of fistula dysfunction. Results In the 436 patients we observed, 245 patients were male, 191 patients were female. Fistula failure was found in 76 cases. Fistula occlusion occurred naturally after kidney transplantation in 138 patients. Conclusion Autologous fistula is the main route for maintenance hemodialysis. Thrombus formation and stenosis cause fistula failure. Diabetes, hypotension and high volume ultrafiltration facilitate the fistula failure. Correct puncture manipulation and appropriate pressure by banding after dialysis prevent the fistula failure.

Key words: Hemodialysis, Arterioveneous fistula, Thrombus