关键词: 动静脉内瘘, 血液透析, 静脉属支, 结扎

Abstract: Ｏｂｊｅｃｔｉｖｅ：To explore efficacy and safety of ultrasound-guided venous branch ligation (UGLVB) in hemodialysis patients with arteriovenous fistula dysfunction.
Ｍｅｔｈｏｄｏｌｏｇｙ：The clinical data, operation plan and postoperative complications of patients who underwent UGLVB in the Department of Nephrology of Beijing Haidian Hospital from January 1, 2018 to September 30, 2022 were collected and analyzed retrospectively. The patients were divided into traditional incision and ligation group and UGLVB group. The baseline data, operation success rate, operation time, wound healing time and complications, patency of internal fistula and treatment cost were compared between the two groups.
Ｒｅｓｕｌｔｓ：A total of 44 patients were enrolled in this study, including 19 patients in UGLVB group and 25 patients in traditional ligation group. The most common reason for the ligation of vein branches is insufficient flow of the trunk (84.09％). The most common ligated vein is the dorsal branch of cephalic vein (54.55％). There was no significant difference in age, sex, basic kidney disease, common disease, dialysis age, internal fistula age, internal fistula opening time, cause and location of venous branch ligation between two groups (P> 0.05). The wound healing time in UGLVB group was shorter than that in the traditional incision and ligation group (2.42±0.51 d vs 12.72±1.49 d,t=-32.256,P=0.000). In terms of complications, there were 1 case of poor wound healing in the traditional incision and ligation group, 2 cases in of mild bleeding UGLVB group, 1 case in the traditional incision and ligation group, and 1 case of nerve injury in the incision and ligation group. There were no serious adverse events such as severe bleeding and infection in both groups.
Ｃｏｎｃｌｕｓｉｏｎ：There is no significant difference in the success rate and complications between the UGLVB group and the traditional ligation of vein branches. The former is superior to the latter in reducing surgical trauma and wound healing, so it is a safe, effective and minimally invasive clinical operation.

Key words: arteriovenous fistula, hemodialysis, venous branch, ligation