【摘要】目的研究终末期肾脏病患者人工血管动静脉内瘘术后静脉吻合口狭窄与静脉血管条件的关系。方法观察2016 年在北京市海淀医院肾内科行人工血管动静脉内瘘手术的138 例患者，收集临床资料尤其是血管情况并进行术后内瘘复查和随访，记录内瘘使用情况和并发症。对人工血管内瘘静脉吻合口狭窄组和非狭窄组的一般资料进行单因素比较，并用Cox 模型进行多元回归分析，以确定相关因素。结果手术部位以肱动脉-头静脉吻合者居多，占54.35%，其次为肱动脉-肘正中静脉，占32.61%；Cox 多因素回归分析显示，吻合静脉的束臂直径(HR 0.672,95% CI 0.453～0.995，P 0.047)是人工血管动静脉内瘘静脉吻合口狭窄需要干预的独立危险因素。结论人工血管动静脉内瘘静脉吻合口短期内狭窄与吻合动脉、静脉直径相关性不大，而与吻合静脉的束臂直径密切相关。

【Abstract】Objective To investigate the role of draining veins in predicting vein anastomotic stenosis of arteriovenous graft (AVG) in patients with end-stage renal disease. Method This is a study regarding 138 cases with AVG at the Renal Department of Haidian Hospital in 2016. Their clinical data including conditions of vessels were collected. Patients were followed up to record the use of graft and its complications. Cox multivariate regression model was used to analyze the relative factors. Result The rate of brachial-cephalic AVG was 54.35% and brachial-median antecubital AVG was 32.61%. Cox multivariate regression analysis showed that the diameter of tourniquet draining vein was the independent risk factor for vein anastomotic stenosis (HR: 0.672, 95% CI: 0.453～0.995, P=0.047). Conclusion The diameter of tourniquet draining vein rather than the diameter of feeding artery and draining vein was significantly associated with vein anastomotic stenosis of AVG,