两种穿刺方法对动静脉内瘘损伤的对比研究

Contrast and research of the two puncture methods for internal arteriovenous rlstula＇s injury

目的比较血液透析中两种穿刺方法对动静脉内瘘的穿刺局部的损伤情况，探讨对血管损伤小、延长内瘘寿命更为科学的穿刺方法。方法40例维持性血液透析患者，透析剂量为2—3次／周，当前内瘘使用年限为3—40个月，随机分为两组，第一组透析穿刺用传统的针头斜面向上方法进行，第二组用针头斜面向下的方法进行穿刺，穿刺由固定的经验丰富的4名护士随机对两组患者进行，分别在穿刺10次及50次后进行观察，在观察前、穿刺10次及50次后对两组血管进行评估，包括穿刺成功率，内瘘并发症（狭窄、动脉瘤），血管彩超。结果根据两组的评估比较出更合理的穿刺方法。结论血液透析中采用针尖斜面向下穿刺法，对血管损伤小，可延长血管使用寿命，是更为科学的穿刺方法。

Objective To compare the partial injury of the two puncture method for internal arteriovenous fistula＇s puncture in hemodialysis and discuss the scientific puncture method which injures a little the blood vessel and can lengthen the lfie of internal fistula Methods There were 40 hemodialysis patients, their hemodialysis doses were 2 to 3 times every week, their internal fistulas＇life were 3 to 40 months. They were randomly divided into two groups, the first group was punctured with the conventional method of the bevel face of syringe needle upward, and the second group was used the method of the conventional method of the bevel face of syringe needle downward. Four skillful nurses operated the two groups patients randomly, and they were observed after being punctured 10 and 50 times. Before they were observed, their blood vessels were estimated after being punctured 10 and 50 times, which included the rate of successful puncture, the complication of internal fistula （narrow, artery tumor）, color doppler imaging of blood vessel Results According to the two group estimation, the more reasonable puncture method was selected. Conclusion The method of the bevel face of syringe needle dowrward used in hemodialysis is more scientific.