自体动静脉内瘘首次穿刺时机对内瘘功能的影响OA

Objective To investigate the effects of the timing of first cannulation of newly created autogenous ar-teriovenous fistulas(AVFs)on the incidence of AVF-related complications and long-term patency.Methods A total of 71 patients who underwent first cannulation of newly created autogenous AVFs at our hospital between May 2022 and A-pril 2024 were enrolled.According to the interval between AVF creation and first cannulation,patients were divided into a very early cannulation group(＜14 days),an early cannulation group(14-21 days),an intermediate cannulation group(22-27 days),and a relatively late cannulation group(≥28 days).A subgroup analysis was also performed using can-nulation within 28 days after surgery as the early-access initiation window and cannulation at ≥28 days as the relatively late-access initiation window.The incidence of complications and the primary and secondary patency rates were compared among the four groups.Results The median time to first cannulation was 12.5,18.5,24.5,and 35 days in the four groups,respectively.No statistically significant differences were observed among the four groups in baseline characteris-tics,history of central venous catheterization,surgical technique,arteriovenous vessel diameter,or laboratory parameters,including serum hemoglobin(Hb),albumin(Alb),and glomerular filtration rate(GFR).The median central venous catheter dwell times were 23 days,30 days,37 days,and 46 days,respectively,showing a significant prolongation with delayed puncture timing(P＜0.001).The 12-month secondary patency rates were 92.9％,100.0％,90.0％,and 94.7％in the four groups,respectively.No statistically significant differences were observed among the four groups in ei-ther primary or secondary patency rates.Conclusion For newly created AVFs that meet cannulation criteria based on physical examination and ultrasonographic assessment,first cannulation within 28 days after surgery does not appear to sig-nificantly increase the risk of access-related complications or secondary patency failure.However,this study did not col-lect data on the duration of central venous catheterization,catheter-related infection rates,or quality-of-life scores.Therefore,the potential clinical benefits of early AVF cannulation require further investigation.