Volume 21 Issue 6
Jun.  2023
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Article Navigation >  Chinese Journal of General Practice  > 2023  >  21(6): 981-984
GAN Yanqun, ZHENG Zhibo. Effect of different arteriovenous fistula puncture methods on the dialysis adequacy of hemodialysis patients[J]. Chinese Journal of General Practice, 2023, 21(6): 981-984. doi: 10.16766/j.cnki.issn.1674-4152.003030
Citation: GAN Yanqun, ZHENG Zhibo. Effect of different arteriovenous fistula puncture methods on the dialysis adequacy of hemodialysis patients[J]. Chinese Journal of General Practice, 2023, 21(6): 981-984. doi: 10.16766/j.cnki.issn.1674-4152.003030
shu

Effect of different arteriovenous fistula puncture methods on the dialysis adequacy of hemodialysis patients

doi: 10.16766/j.cnki.issn.1674-4152.003030

  • Blood Purification Center, Zhejiang Hospital, Hangzhou, Zhejiang 310013, China

Funds:

 2022RC093

  • Received Date: 2022-09-01
    Available Online: 2023-08-26
    Abstract
  •   Objective  Arteriovenous puncture technique can significantly affect the adequacy of dialysis. This study aims to explore the differences in the impact of different puncture methods on dialysis adequacy for clinical practice reference.  Methods  A total of 217 patients who underwent hemodialysis at the Blood Purification Center, Zhejiang Hospital from January 2020 to October 2021 were selected as the research objects. Regional, rope ladder, and buttonhole puncture methods were used, and patient clinical information was collected. The adequacy of dialysis was compared by the average urea clearance index (Kt/V) and urea reduction rate (URR) within 6 months after dialysis. Logistic regression analysis was used to explore the related influencing factors.  Results  The average age of the patients was (55.6±2.8) months, and the average use time of the arteriovenous fistula was (45.3±1.6) months. Among the puncture techniques, 116 cases (53.5%) used regional puncture, 70 cases (32.2%) used rope ladder puncture, and 31 cases (14.3%) used buttonhole puncture. There was a significant correlation between Kt/V, URR values and the location of the arteriovenous fistula. Patients with brachial artery-cephalic vein fistula had better Kt/V and URR values than those with radial artery- cephalic vein fistula (P=0.002, 0.028). Puncture needle direction along the blood flow direction increased Kt/V by 0.892 times (95% CI: 0.851-0.963, P=0.033), while puncture method, arterial needle rotation, whether the arterial and venous needles were in the same vascular segment had no significant effect on Kt/V, URR values, and dialysis adequacy (all P>0.05).  Conclusion  When the direction of the puncture needle is consistent with the blood flow direction in arteriovenous fistula puncture, it can increase the adequacy of hemodialysis. Different puncture methods, arterial needle rotation after insertion, and whether the arterial and venous needles are in the same vascular segment do not have a significant effect on dialysis adequacy.

     

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