【摘要】随着血液净化技术的发展，血管通路也经历了漫长的发展过程。动静脉外瘘、动静脉内瘘的出现是血管通路发展史上里程碑，到目前为止，动静脉内瘘仍是不可替代的最主要的永久性血管通路。移植物内瘘为无法建立自体动静脉内瘘患者提供了选择，聚四氟乙烯(polytetrfluroethylene,PTFE)仍是目前应用最广泛的移植物，生物工程人造血管的临床应用前景值得期待。中心静脉导管曾发挥重要作用，目前主要作为过渡通路应用广泛，未来需继续改进移植物及导管材质及构型以改善长期通畅性。对于血管通路工作者而言，工作重点需由通路建立转移至早期血管资源的保护，合理的血管通路规划，适时的通路监测及干预维护。

【Abstract】In the developmental processes of blood purification, vascular access undergoes a long period of progression. The application of Quinton-Scribner shunt and Brescia-Cimino fistula is a milestone in the developmental history of blood access. Currently, internal arteriovenous fistula is the preferential and essential method of permanent blood access. Arteriovenous graft provides an alternative for patients without suitable vessels for autologous fistula; polytetrafluoroethylene is widely used for the graft and bioengineered blood vessels are expected to be used clinically in the nearly future. Central vein catheterization played an important role for blood access and nowadays is commonly used as a transitional measure. The continuous improvement of material and structure of the graft and long-term patency of the graft are imperative. Medical staff working for blood access should put their focuses on early protection of vascular resources and rational planning, monitoring and maintenance of the blood access after establishment of vascular access route.