两种穿刺法在自体动静脉内瘘患者中的效果比较

Comparison of two puncture methods in patients with autogenous arteriovenous fistula

目的:探讨扣眼穿刺与绳梯穿刺这两种方法在自体动静脉内瘘血液透析患者中的应用效果,为选择更安全有效的穿刺方法提供依据,进而延长内瘘使用寿命,提升透析效果,提高患者生存质量。方法:选择使用自体动静脉内瘘进行维持性血液透析治疗的患者34例,随机等分为扣眼穿刺组和绳梯穿刺组,比较进行血液透析治疗10个月后两组在一次穿刺失败率、内瘘并发症(血管瘤、血管狭窄、血栓形成、内瘘感染)的发生率、透析过程中渗血发生情况及患者的疼痛评分情况。结果:两组患者内瘘并发症(血管瘤、血管狭窄、血栓形成、内瘘感染)的发生率以及渗血发生情况比较差异无统计学意义(P>0.05),扣眼穿刺组一次穿刺失败情况、疼痛评分均低于绳梯穿刺组,差异有统计学意义(P<0.05)。结论:扣眼穿刺法可以有效降低穿刺难度,减少患者疼痛,值得临床推广使用。

Objective：To explore the application of buttonhole puncture and rope ladder puncture in hemodialysis patients with autogenous arteriovenous fis- tula and to provide the basis for selecting more safe and effective puncture method, so as to prolong the service life of internal fistula, enhance dialysis effect and improve the quality of life of patients. Methods ： A total of 34 hemodialysis patients with autogenous arteriovenous fistula were randomly divided into but- tonhole puncture group and Rope ladder puncture group. After 10 months of hemodialysis treatment, the failure rate of one group Fistula complications （ he- mangioma, vascular stenosis, thrombosis, fistula infection） incidence, the incidence of dialysis and the incidence of bleeding in patients with pain score were analyzed. Results：The incidence of fistula complications （hemangioma, vascular stenosis, thrombosis, fistula infection） and oozing occurred in two groups were not statistically significant （P 〉 0.05 ）. The buttonhole puncture failure and pain scores were lower than that of rope ladder puncture group. The difference was statistically significant （ P 〈 0.05 ）. Conclusion： The buttonhole puncture method can effectively reduce the difficulty of puncture, reduce pain in patients, it is worthy of clinical application.