内瘘侧肢体行为规范的建立对维持性血液透析患者内瘘并发症的影响

The effect of limb behavioral norms on complications of internal fistula in maintenance hemodialysis patients

目的探讨肢体行为规范的建立对降低维持性血液透析患者内瘘并发症发生率的影响。方法选取2014年6~12月我院新导入的首次使用动静脉内瘘(arteriovenous fistula,AVF)的维持性血液透析患者31例为对照组,选取2015年1~6月新导入且首次使用AVF的维持性血透患者33例为观察组。对照组采用传统的健康教育内容对患者进行健康教育,观察组患者采用更为细致的肢体行为规范作为教育内容对其进行健康教育,1年后对两组患者内瘘并发症的发生情况进行比较。结果 1年后,观察组患者的内瘘血栓形成(χ~2=4.399,P=0.036)、闭塞(χ~2=4.373,P=0.037)、内瘘血流量降低(χ~2=4.510,P=0.034)的发生率显著低于对照组,且差异具有统计学意义,观察组和对照组内瘘感染的差异无统计学意义(χ~2=1.081,P=0.298)。结论建立肢体行为规范能够降低患者内瘘血栓形成、闭塞和内瘘血流量降低的发生率。

Objective To investigate the influence of limb behavioral norms on the complications of internal fistula in maintenance hemodialysis（MHD） patients Methods Thirty-one MHD patients who received arteriovenous fistula（AVF） for the first time in our hospital from Jun. 2014 to Dec. 2014 were selected as the control group, and 33 MHD patients who received AVF for the first time in our hospital from Jan. 2015 to Jun.2015 as observation group. The control group adopted the traditional health education, and the observation group established more detailed norms of physical behavior. The fistula complications were compared between the two groups after one year. Results After one year, the incidence of thrombosis（χ^2=4.399, P=0.036）,stenosis and occlusion（χ^2=4.373, P=0.037）, decreased blood flow in AVF（χ^2=4.510, P=0.034） were significantly lower in observation group than in control group, and the differences were statistically significant. Fistula infection was not statistically significant（χ^2=1.081, P=0.298） between the two groups. Conclusion The establishment of limb behavioral norms can reduce the incidence of fistula thrombosis, occlusion and fistula blood flow reduction in MHD patients.