Abstract: 【Abstract】Objective To investigate the effect of color Doppler ultrasonography on the application of rope ladder puncture for arteriovenous fistula in hemodialysis patients. Methods We recruited 128 hemodialysis patients first using arteriovenous fistula for blood access in the period from January 2017 to June 2017. They were randomly divided into control group and observation group according to the sequence of initial use of arteriovenous fistula. In the control group, the traditional rope ladder method was used. In the observation group, color Doppler ultrasonography was used to draw the rope ladder puncture site. The success rate of once puncture, implementation rate of rope ladder puncture technique, patient satisfaction rate, compliance rate of online clearance monitoring (online Kt/V), moderate pain rate during puncture and fistula complication rate were followed-up for 6 months to analyze the differences between the two methods. Results The satisfaction rate of observation group was higher than that of control group (100% vs. 73%, χ2=10.012, P=0.001). The execution rate in observation group was much higher than that in control group (100% vs. 46%, χ2=16.123, P＜0.001). The online Kt/V compliance rate in observation group was significantly higher than that in control group (95% vs. 80%, χ2=7.479, P=0.008). The incidence of moderate puncture pain (3% vs. 30%, χ2=9.729, P=0.003) and arteriovenous fistula complications (1% vs. 20%, χ2=8.279, P=0.005) in observation group were also much lower than those in control group. There was no significant difference in the success rate of once puncture between the observation group and the control group (97% vs. 96%, χ2=0.187, P=0.657). Conclusion The rope ladder puncture under the guidance of color Doppler ultrasonography can help nurses better manipulate the puncture technique, reduce the vascular complications caused by puncture, ameliorate moderate pain rate of the patients, prolong the service life of the internal fistula, and improve dialysis effect and treatment satisfaction of the patients.

Key words: hemodialysis, arteriovenous fistula, Rope ladder puncture under the guidance of color Doppler ultrasonography, Puncture complication