血液透析常用血管通路的选择与维护

血管通路是血液透析患者的生命线，及时建立和维护血管通路功能十分重要。老年人及糖尿病肾病的增多增加了建立内瘘的难度，各个专科技术和治疗手段的拓展影响了血管通路的建立，以及患者透析时间延长导致血管耗竭都使得血管通路医生面临巨大挑战。本文提出了目前的一些有关临床问题，强调保护好血管资源，正确选择血管通路；并进一步介绍维护内瘘通畅和实时介入干预技术，同时强调了分享带涤纶套隧道导管的应用与管理经验，也强调多学科合作，发展介入肾脏病学。

Selection and maintenance of commonly used vascular access in hemodialysis

Vascular access is the lifeline of hemodialysis patients. It is very important to establish vascular access in time and maintain the vascular access in good-function. The increase of the elderly and diabetic nephropathy has increased the difficulty of establishing internal fistula. The expansion of various specialized techniques and treatment methods has affected the establishment of vascular access, and the dialysis time extension has exhausted blood vessels. All of the above has made vascular access physicians face enormous challenges. This paper paid attention to some clinical issues to protect blood vessel resources, analyzed for correct selection of vascular access, further introduced maintenance of the internal fistula and real-time intervention techniques, shared the application and management experience of the tunnel catheters with polyester sleeves, and emphasized multidisciplinary cooperation to develop intervention nephrology.