【摘要】 目的 探讨动静脉内瘘成熟期内穿刺方法，减少早期使用内瘘的并发症。方法 将28例内瘘成形术后2～4周的尿毒症患者随机分为两组，对照组14例在穿刺时选择常规两点，即动脉针在内瘘吻合口近心端3～6cm穿刺，静脉穿刺点离开动脉穿刺点5～10cm穿刺。观察组14例的动脉穿刺点在内瘘吻合口近心端10cm左右，静脉穿刺选择患者其他肢体的表浅静脉。观察两组患者穿刺成功率、透析血流量不足及皮下血肿发生率。结果 观察组穿刺成功率(100%)明显高于对照组(85.7%)，而皮下血肿发生率(50%)明显低于对照组(0)，两组患者的透析血流量不足发生率无明显区别。结论 动静脉内瘘成熟前穿刺时将动脉针穿刺内瘘，而静脉针穿刺其他肢体浅表静脉，可减少相关并发症，提高穿刺成功率。

    【关键词】 动静脉内瘘； 成熟； 穿刺

    【Abstract】 Objective To select a single-needle to puncture a maturiephase (2-4week)AVF, comparatively prolonged AVF maturity-phase, in order to reduce bleeding under the skin in early puncture and reduce the complication of a new AVF.Methods Choosing 28 cases of chronic uremia patients . When you are using a formed AVF(2～4weeks),divided into two groups and choose different positions of injection：for the first group of patients, choose two normal positions. It means the punctured position in the vein is above the AVF coincided position by 5～6 cm.The punctured position in the vein is above the punctured position in the artery by 5～10cm. For the second group of patients,the punctured position in the vein is above the AVF coincided position by 10cm. Choosing shallow vein to puncture. By means of comparing the first group with the second one to observe the situation of new AVFs.Result Seven of the first group bring out blood vessels swelling.None of the second group has aberrant situation.Conclusion Prolong the AVF’s life, in order to reduce the complication of a new AVF and the pain of patients. ......