Abstract: 【Abstract】Objective To provide the basis for longer use of arteriovenous fistulas, we explored the withdrawal time of the punctured needles after hemodialysis on hemostasis time, exudative bleeding rate and hematoma formation rate at the punctured area, and internal fistula complications in maintenance hemodialysis (MHD) patients with freshly used internal fistulas. Methods A self- control method was carried out for 40 new MHD patients with freshly used internal fistulas. The punctured needle was withdrawn immediately or delayed for 10 min, and the punctured site was pressed for about 10 min after withdrawal. The first 10 punctures with a total of 400 punctures were analyzed. The pressed duration on punctured site and the internal fistula complications were analyzed between immediate withdrawal of the needles after hemodialysis and delayed withdrawal of the needles for 10 min. Results ①Press duration for hemostasis was (7.16±2.08)min and (13.68±3.21) min (t =-10.765, P＜0.001) for delayed and immediate withdrawal of the needles, respectively. Local bleeding volume was 0.98±1.03 ml and (4.15±1.55) ml (t=-10.83, P＜0.001) for delayed and immediate withdrawal of the needles, respectively. ②The prevalence of exudative bleeding, hematoma, and numbness/ swelling was 38.00%, 0.00% and 6.00%, respectively for delayed withdrawal of the needles, and was 51.50%, 4.00% and 22.50%, respectively for immediate withdrawal of the needles (χ2=7.371, 8.163, 25.823, respectively; P＜0.01). Conclusion The needle punctured into internal fistula should be remained in situ for 10 min after hemodialysis, and the punctured site was pressed after withdrawal. This method can significantly reduce
the incidence of early fistula complications and extend the useful period of the fistulas.

Key words: Hemodialysis, Arteriovenous fistula, Delayed withdrawal of needle