Abstract:

Objective To investigate the fistula obstruct ion reasons and the treatments to prevent the obstruction.Methods Fourty-one patients of 183 maintenance hemodialysi s patients suffered from vascular fistula obstruction. Hemoglobin(Hb), platelet(plt), albumin(Alb), triglyceride(TG), cholesterol(CHO) and haematocrit values(HCT) were compared between before obstruction and after obstruction. Age, sex, Hb, Plt, ALB, TG, CHO, HCT and the duration of fistula usage were compared between the 41 obstruction patients and 142 non-obstruction patients with logistic method. Results Fistula obstruction occurred at the early stage of the maturation, the incidence of obstruction was 22.4%(41/183). There were signi ficant difference between the two group of the increase of Hb, Plt and the decrea se of ALB (P<0.0001). Conclusion To prevent the vascular obstruction especially at the early stage of the fistula maturation, improve the nutrition status such as increase plasma albumin, increase Hb slowly with EPO and anti-coagulate therapy properly are effective. To puncture by step, press with a proper power at one point after dialysis and educate the patients and their relatives on how to protect fistula are also very important.

Key words: Fistula obstruction, Caring st rategy 