改良湿感应器在内瘘穿刺针滑脱预警中的应用

Application of improved wet sensors in the early warning of internal fistula needles prolapse

目的探讨湿感应器对内瘘穿刺点渗血、出血的预警效果，杜绝内瘘穿刺针滑脱现象的发生。方法2012年1月，选择符合课题设计要求的市售湿感应器，并进行技术改良。应用生理盐水反复对湿感应器进行感应报警敏感度测试。通过90例次的对比实验，找出最佳的感应报警点，再将其应用于临床研究。2012年1—6月，采用目的抽样方法，选择60例采取动静脉内瘘穿刺进行血液透析治疗的患者，应用改良后的湿感应器对内瘘穿刺点渗血和出血进行监控。结果电阻值为1．2M12和2．2M12的湿感应器与电阻值为2000n的湿感应器对生理盐水的感应报警敏感度比较，差异有统计学意义（t值分别为19．91，20．13；P〈0．01）；电阻值为1．2MQ的湿感应器与电阻值为2．2MQ的湿感应器对生理盐水的感应报警敏感度比较，差异无统计学意义（t=1．43，P〉0．05）。当渗血分别为（1．21±0．49）ml和（1．12±0．50）ml时，电阻值为1．2MQ和2．2Mn的湿感应器即发出报警，两者对血液的感应报警敏感度比较，差异无统计学意义（t=0．73，P〉0．05）。结论湿感应器可有效地对内瘘穿刺点渗血、出血进行监控和预警，从而防止内瘘穿刺针滑脱现象的发生，避免透析意外事件对患者的伤害。

Objective To explore the warning effect of the improved wet sensor in the oozing and bleeding of internal fistula puncture site, so as to prevent the phenomenon of fistula needle slippage. Methods From January 2012 to June 2012, to select the 60 patients who accepted hemodialysis treatment by arteriovenous fistula needle, then to monitor the blood oozing and bleeding of fistula needle point with the improved wet sensors. Results The saline induction alarm sensitivity between the wet sensors with resistance value of 1.2 MΩ and 2.2 MΩ and the wet sensors with value of 2 000 Ω, significant differences were found （ t = 19.91,20.13 ;P 〈 0. 01 ）. While no significant difference was found in saline induction alarm sensitivity between the wet sensors with resistance value of 1.2 MΩand of 2.2 MΩ （ t = 1.43, P 〉 0.05 ）. The sensitivity of wet sensors with resistance value of 1.2 MΩ and 2.2 MΩ was higher, when the oozing amount reached （1.21 ± 0.49）ml and （1.12 ±0.50）ml, they were alerted. While there was no significant difference was found between them （t = 0.73, P 〉 0.05 ）. Conclusions The wet sensor can effectively monitor and early warning the oozing and bleeding during the operation of internal fistula puncture point, and can effectively prevent the phenomenon of fistula needle slippage and avoid the harm of dialysis accident.