改良穿刺法延长血液透析患者动静脉内瘘使用寿命的观察

The observation and nursing on improved puncture to the time of service of internal arteriovenous fistula in patients with hemodialysis

目的观察使用改良穿刺法对延长血液透析患者动静脉内瘘使用寿命的效果。方法将维持性血液透析患者84例随机分为观察组和对照组各42例,观察组采用动脉端向心方向穿刺法,对照组采用动脉端离心方向穿刺法,两组患者静脉端均为向心方向穿刺。观察两组内瘘并发症包括动脉瘤、内瘘狭窄、内瘘阻塞的发生率,同时比较两种穿刺方式的透析效率包括尿素氮及肌酐清除率。结果观察组发生并发症明显少于对照组(P<0.01),差异有统计学意义,且不影响透析效率。结论动脉端向心方向穿刺法能保证透析效率,降低内瘘并发症的发生率。

Objective The aim of the study was to observe effect of improved puncture to the time of service of internal arteriovenous fistula in patients with hemodialysis. Methods 84 patients who were undergoing hemodialysis were randomly divided into two groups,the observation group 42 cases with the puncture direction towards the heart in the artery,the control group 42 cases with the puncture direction away from the heart in the artery,and all the patients underwent puncture with direction towards the heart in the vein,to compare the incidence rate of complication including aneurysm ,stenosis of internal fistula, obstruction of internal fistula and the effect of hemodialysis （including blood urea nitrogen, BUN and creatinine clearance rate, Ccr）. Results The incidence rate of complication in observation group was significantly reduced than that in control group （ P 〈 0.01 ）, and the effective rate of hemodialysis did not reduce significantly. Conclusion The puncture direction towards the heart in the artery can remain effective rate of hemodialysis and the reduce the incidence rate of complication.