维持性血液透析患者动静脉内瘘阻塞的原因分析及预防对策

目的：分析维持性血液透析患者动静脉内瘘阻塞的原因，制定相关的预防对策。方法记录动静脉内瘘的使用情况，统计患者开始透析时间，动静脉内瘘开始使用时间和失功时间。结果117例使用动静脉内瘘患者中，发生内瘘阻塞12例，占10.3%。12例发生内瘘阻塞者中高血压10例、糖尿病肾病7例、红斑狼疮肾炎5例、多囊肾2例；高凝状态所致5例，超滤量过多4例，压迫时间过长2例，内瘘使用过早1例。结论对原发病进行积极治疗，正确选择血管，进行有效的术后护理，避免过早使用内瘘并对患者进行健康教育，积极预防内瘘阻塞的发生。

Cause analysis and preventive measures for arteriovenous fistula obstruction in patients with maintenance hemodialysis

Objective To analyze the causes of arteriovenous fistula obstruction in patients with maintenance hemodialysis and develop corresponding preventive measures. Methods The study monitored the use of arteriovenous fistula and recorded the start time of hemodialysis, and the start time and dysfunction time of arteriovenous fistula. Results 12 cases （10.3%） of fistula obstruction were observed in 117 patients using arteriovenous fistula. Among the 12 cases of fistula obstruction, 10 cases of hypertension, 7 cases of diabetic nephropathy, 5 cases of lupus nephritis and 2 cases of polycystic kidney disease were observed. Among the 12 cases of fistula obstruction, 5 cases were caused by hypercoagulable state, 4 cases caused by ultrafiltration, 2 cases caused by long-time oppression, and 1 case caused by premature fistula. Conclusion Aggressive treatment of primary diseases, proper selection of blood vessels, effective postoperative care, avoiding premature fistula, and health education can actively prevent occurrence of fistula occlusion.