张启丽 彭春香 甘措

    【摘要】? 自体动静脉内瘘是血液透析患者最常用的血管通路，在临床上证明是最佳的长期血管通路，但临床穿刺过程中发现，对疑难内瘘血管的穿刺成功率偏低，给患者带来极大的痛苦，加重患者的心理负担，内瘘的使用寿命也一般比较短，严重影响血液透析的质量，并提高了住院率和死亡率。文章主要从疑难内瘘的特点、穿刺方式的选择、护士穿刺观念与管理以及穿刺要点等方面进行综述，希望进一步提高内瘘穿刺成功率，提升护理质量，降低自体动静脉内瘘并发症的发生，延长内瘘血管使用寿命，改善患者结局，推动相关技术的不断完善与探索在疑难内瘘穿刺过程中发挥更重要的作用。

    【关键词】? 血液透析；疑难动静脉内瘘；穿刺方法；穿刺技巧；护士管理

    中图分类号? R692.5? ?文献标识码? A? ? 文章编号? 1671-0223(2024)13--04

    Research progress of difficult arteriovenous fistula puncture in hemodialysis patients? Zhang Qili， Peng Chunxiang， Gan Cuo. Chengdu Jinniu People's Hospital， Chengdu 610036， China

    【Abstract】? Autologous arteriovenous fistula is the most commonly used vascular access for hemodialysis patients， which has been clinically puncture， it is found that the puncture success rate of difficult internal fistula vessels is low， which brings great pain and aggravates the psychological burden of patients. The service life of internal fistula is generally short， which seriously affects the quality of hemodialysis. And increased hospitalization and mortality rates. This paper mainly reviewed the characteristics of difficult internal fistula ......