远红外线照射联合马铃薯外敷治疗动静脉内瘘皮下血肿的临床研究

Far Infrared Therapy with External Application of Potato Slice for Arteriovenous Fistula Subcutaneous Hematoma

目的探讨远红外线照射联合新鲜马铃薯片外敷治疗自体动静脉内瘘皮下血肿的临床效果。方法用随机数字法,将90例动静脉内瘘因穿刺失败等发生皮下血肿伴疼痛的血液透析患者随机分成3组,每组30例,观察组用远红外线照射联合新鲜马铃薯片外敷;两对照组分别用50%硫酸镁湿敷和喜疗妥乳膏外擦,对比观察3组间皮下血肿伴疼痛的治疗效果,并对6月后内瘘血管狭窄、栓塞等并发症及血流量进行分析比较。结果观察组较硫酸镁组和喜疗妥组疼痛完全消失时间短,3组间差异有统计学意义(P=0.000),内瘘皮下血肿消退时间比较,观察组较两对照组血肿消退快,3组间差异有统计学意义(P=0.000),6个月发生内瘘血管狭窄及内瘘血流量等方面均明显优于对照组,3组间的差异有统计学意义(P<0.001),但在6个月内瘘血管栓塞发生率方面,3组间差异无统计学意义(P>0.05)。结论远红外线照射联合马铃薯片外敷可有效治疗动静脉内瘘皮下血肿伴疼痛,减少内瘘血管狭窄,提高内瘘的通畅率,延长内瘘使用时间,效果优于单独使用50%硫酸镁湿敷或喜疗妥外擦。此护理方法无创、安全且简单方便,值得临床推广应用。

Objective To explore the effect of far infrared therapy combined with external application of potato slice for treating subcutaneous hematoma caused by arteriovenous fistula （AVF）. Methods Ninety hemodialysis patients with subcutaneous hematoma caused by AVFs were randomly divided into observation group, magnesium sulfate group and Hirudoid group, 30 patients in each group. To treat AVFs subcutaneous hematoma, far infrared radiation with external application of fresh potato slice was applied in observation group; external application of 50% magnesium sulfate in magnesium sulfate group and external application of Hirudoid cream in Hirudoid group. The pain degree and hematoma diameters were observed and recorded. AVFs stenosis, thrombosis and blood flow were monitored. Results Comparison of the effect of pain-relieving, the average time when AVFs complication pain disappeared in groups indicated statistical significance （P=0.000）. Comparison of the average healing time of AVFs hematoma in groups indicated statistical significance （P=0.000）. Comparison of 6 months AVFs stenosis rate and blood flow in groups indicated statistical significance （P〈0.001）. But AVFs thrombosis rate indicated no statistical difference in groups （P〉0.05）. Conclusion Far infrared radiation therapy combined with external application of potato slice is effective for treating AVFs complications compared with external application of 50% magnesium sulfate and external rubbing Hirndoid. It＇s a safety and noninvasive way for treating AVFs subcutaneous hematoma, preventing AVFs stenosis, improving its patency rate, and prolonging AVFs function time. No patients complained of any adverse effect.