集束化干预策略在预防血液透析患者自体动静脉内瘘失功中的应用

Application of care bundle in the dysfunction prevention of internal arteriovenous fistula in hemodialysis patients

目的探讨集束化干预策略在预防血液透析患者自体动静脉内瘘(AVF)失功中的应用。方法采用前瞻性随机对照研究设计,选择2018年3月至2019年12月在郑州大学第一附属医院行AVF成形术并使用AVF规律血液透析的患者120例,采用随机数字表法随机分为干预组和对照组,每组60例。干预组在系列循证护理的基础上实施部分常规护理加集束化干预策略,干预时间为行AVF成形术到规律血液透析6个月;对照组实施常规护理。6个月后对两组患者的AVF失功率、患者满意度及患者自我管理能力进行比较。结果干预组AVF失功率为13.3%,对照组为35.0%,两组差异具有统计学意义(P<0.05)。干预组患者满意度及自我管理能力均优于对照组,差异具有统计学意义(P<0.05)。结论集束化干预策略可有效降低血液透析患者AVF失功的发生率,提高患者满意度及自我管理能力。

Objective To investigate the application of care bundle in the dysfunction prevention of internal arteriovenous fistula(AVF)in hemodialysis patients.Methods 120 patients who underwent AVF surgery in the first affiliated hospital of Zhengzhou university from January 2015-December 2016 were enrolled in this study,and randomly divided into intervention group(n=60)and control group(n=60).The intervention group received ventilator care bundle on the basis of routine nursing,and the intervention time period was 6 months since the operation of AVF.The control group received routine nursing.Dysfunction of AVF,patient satisfaction and self-management were compared between the two groups.Results The percentages of AVF dysfunction in the intervention group and the control group were 13.3%and 35%,respectively,and there was no statistically significant difference between the two groups(P<0.05).Satisfaction and self-management ability of patients in the intervention group were significantly better than those in the control group(P<0.05).Conclusion Ventilator care bundle can effectively reduce the incidence of dysfunction in AVF and improve patients’satisfaction and self-management ability.