Arteriovenous endovascular fistula is a long-term vascular access for chronic dialysis patients, through which they can perform maintenance hemodialysis to maintain their lives, so the vascular access is also called the “lifeline” for chronic renal failure patients. The endovascular fistula is a vascular channel established by surgically anastomosing the adjacent arteries and veins of the limb, usually the radial artery of the upper limb and the cephalic vein are anastomosed, and through the vascular channel, arterial blood is diverted to the vein, and the vein expands due to increased blood flow and pressure, forming an arterialized vessel that gradually becomes thicker and easier to puncture directly during dialysis, providing convenience for dialysis treatment and ensuring adequate blood flow. How to prevent and control arteriovenous fistula occlusion, and do a good job of long-term maintenance of endovascular fistula? The author, based on many years of clinical experience, combined with the problems that kidney patients tend to ignore, briefly summarized the following considerations, I sincerely hope that the patients dialysis smooth, happy life! 1, within a few days after the internal fistula anastomosis, the surgical site may have bruising, swelling and other uncomfortable symptoms, this is the normal reaction after surgery, do not worry. You should keep the wound site clean and dry, change the dressing in time, and ask the specialist to observe the development of the internal fistula. The operated limb should be elevated and avoid blood pressure measurement and venipuncture to ensure that the surgical site is not compressed, do not carry heavy objects on the operated limb, and do not wear a watch or bracelet. The fingers of the operated side can be used to support the fist movement, squeeze the rubber ball, etc. Spectrum irradiation can be given to the skin of the operated field before the wound is healed and the sutures are removed, and hot water can be used to soak or apply hot compresses to the vascular part of the fistula after the healing and removal of the sutures (10-14 days after surgery) to promote the maturation of the fistula. 2, the fistula is not mature should not be used prematurely, especially for diabetic, hypertensive, elderly patients should establish temporary vascular access (internal jugular vein or femoral vein indwelling catheter) as a transition to reduce endovascular injury, until 4-6 weeks after the fistula is fully mature before use. 3, for dialysis patients with mature endovascular fistula, nurses are required to operate skillfully and try to puncture once successfully to reduce the damage to the endovascular vessels caused by the puncture needle and the vascular compression caused by local blood leakage. The use of rotational puncture method of endovascular fistula can reduce vascular damage to prevent the formation of pseudoaneurysm and vascular malformation, resulting in local stenosis of damaged vessels. 4, after the end of dialysis puncture point compression time should not be too long, generally about 1 hour, while the pressure should not be too large, to vary from person to person, to the principle of no bleeding. 5, usually pay attention to keep the skin of the endovascular site clean, pay attention to the sleep position to prevent compression, and check the operation of the endovascular every day by yourself (listen to the vascular murmur, touch the vascular tremor, etc.). If you find any abnormality in the fistula (weakening or disappearance of tremor) or redness, swelling, heat or pain at the puncture site, contact the specialist or nurse as soon as possible so that you can get timely treatment. The limb with the internal fistula should be kept free of weight, pressure and blood pressure for a long time, and no vascular puncture, intravenous infusion or any other operation that may damage the blood vessels, except for hemodialysis. The actual fact is that you will be able to use “Xitropin”, hot water soaking or hot compress to protect the internal fistula blood vessels, and to keep warm in winter. 7, the use of erythropoietin (blood, domestic erythropoietin) kidney friends, should be regularly checked hematocrit, hematocrit, to prevent the hematocrit rise too fast (generally not more than 20 grams per liter per month), blood in a hypercoagulable state can easily lead to thrombosis. 8, hemodialysis water should be accurate to prevent the occurrence of hypotensive shock. Kidney friends should control water intake during dialysis, try to achieve weight gain of no more than 4% of dry weight, generally controlled within 2.5 kg, to prevent excessive ultrafiltration in a short period of time, resulting in insufficient blood volume, blood pressure drop and lead to internal fistula occlusion.