血液透析中内瘘血管两种不同穿刺方法运用的临床观察

Arteriovenous Fistula in Hemodialysis Vascular Clinical Observation of Two Different Puncturing Methods Used

目的比较改进后的动脉端针尖向心方向穿刺内瘘术与常用动脉端针尖逆心方向穿刺内瘘术的优缺点。方法选取我院2008年1月至2011年1月,采用穿刺内瘘术行血液透析的慢性肾功能衰竭患者60例,随机分为甲、乙两组。甲组采用常用的动脉端针尖逆心方向穿刺术,乙组采用动脉端针尖向心方向穿刺术,血液透析为每周2次,共随访观察3年,对两组病员的肌酐下降率及假性动脉瘤形成率进行对比分析,比较其优缺点。结果改进后的动脉端针尖向心方向穿刺内瘘术较动脉端针尖逆心方向穿刺术假性动脉瘤形成的机率减小,肌酐下降率基本相同。结论动脉端针尖向心方向穿刺术较动脉端逆心方向穿刺术能较有效地预防假性动脉瘤形成,并未增加再循环,也不降低透析效率,可在血液净化中推广应用。

Objective Compared with the improved artery end needle-tip centripetal direction puncture in fistula technique and in commonly used artery end needle-tip not to one＇s liking direction puncture the good and bad points of fistula technique. Method Selected my institute in January 2008 to January 2011, in chronic kidney failure patient 60 of fistula technique good hemodialysis with puncture, was divided into A and B two groups stochastically. The starting team uses the commonly used artery end needle-tip not to one＇s liking direction puncture method, the second division uses the artery end needle-tip centripetal direction puncture method, the hemodialysis for each week two, altogether the follow-up three years, to the creatinine descending rate and pseudo aneurism speed of formation of two groups of patients compare analyze, compared with its good and bad points. Result The probability that in the improved artery end needle-tip centripetal direction puncture the fistula technique artery end needle-tip not to one＇s liking direction puncture method pseudo aneurism forms reduces, the creatinine descending rate is basic. Conclusion The artery end needle-tip centripetal direction puncture method artery end not to one＇s liking direction puncture method can effectively prevent the pseudo aneurism to form, has not increased the recycling, does not cut the dialysis efficiency, may the application and spreading in the blood purification.