针尖斜面向下穿刺动静脉内瘘减轻患者疼痛的效果

Therapeutic Observation on Puncture to Arteriovenous Fistula with Pinpoint Plane Downward to Alleviate Pains

目的探讨针尖斜面向下穿刺动静脉内瘘减轻患者穿刺时疼痛强度的效果。方法采用方便抽样法选择20名维持性血液透析患者,采用自身前后对比的方法,每人针尖斜面向下穿刺10次、传统针尖斜面向上穿刺10次,两种方法隔次采用,且每次均采用口述性疼痛测定方法和简化版马克盖尔疼痛问卷（SF-MPQ）进行疼痛强度评分。比较两种穿刺方式时患者疼痛的程度及穿刺成功率,并同时使用血液透析机的在线尿素清除率监测功能检测并记录患者的透析充分性。结果两种穿刺方式对患者造成的疼痛强度差异有统计学意义（P〈0.05）,透析充分性和穿刺成功率方面两种方法无明显差异（P〉0.05）。结论针尖斜面向下穿刺在保证透析充分性和穿刺成功率的基础上,能够有效减轻患者穿刺时的疼痛,减轻患者的恐惧心理,值得临床推广应用。

Objective To investigate the effect of pain-relief with pinpoint plane downward to anteriovenous fistula.Methods With own-contrast,20patients,who were receiving maintenance hemodialysis,received punctures with pinpoint plane downward for 10times and upward for 10times for each person.The two methods of punctures were used in turn,and the levels of pains were scored by oral method and SF-MPQ method.The pain levels of the two puncture methods were compared.The success rate of puncture and sufficiency of hemodialysis were recorded while the dialysis adequacy were recorded and measured by the online clearance monitoring function of hemodialysis machines.Results The pain levels of the two punctures were significantly different（P0.05）,and no significant difference was observed on the success rate of puncture sufficiency between the two groups（P0.05）.Conclusion On the premise of ensuring the dialysis adequacy and the success rate of puncture,puncture to arteriovenous fistula with pinpoint plane downward can effectively reduce pain and fear in patients with puncture,which deserves clinical popularization.