改进持针部位在动静脉内瘘钝针穿刺术中的应用效果评价

Evaluation of the Application Effect of Improved Needle-holding Positions on Arteriovenous Fistula Cannulation by Buttonhole Technique Using Blunt Needle

目的探讨钝针不同持针部位在动静脉内瘘穿刺中的应用效果。方法便利抽样选取2016年1-11月,在上海曙光医院血液净化室行钝针扣眼穿刺法患者30例,随机分为A、B、C三组,A组手持针翼部位,B组手持穿刺针后部据针柄1cm处的软管,C组手持穿刺针后部据针柄2cm处的软管,比较三组患者一次穿刺成功率以及疼痛耐受性之间的差异。结果在一次穿刺成功率和疼痛耐受性方面比较,B组患者均优于A、C组,差异均有统计学意义(均P<0.05);而对不同年资穿刺者在在一次穿刺成功率及患者疼痛耐受性方面的比较,A、C组具有统计学意义(P<0.05),B组无差异(P>0.05)。结论手持穿刺针后部距针柄1cm处的软管的持针部位,能提高一次穿刺成功率、减少穿刺疼痛,对护理人员年资要求相对较低。

Objective To explore the application effect of different needle-holding positions of arteriovenous fistula cannulation by buttonhole(BH)technique using blunt needle.Methods By convenience sampling,30 hemodialysis patients were selected and randomly divided into group A,B,C by different needleholding positions:holding the wings of the needle(group A),holding the flexible tube 1 cm(group B),2 cm(group C)from the needle handle.Compare the achievement ratio and pain tolerance of different groups.Results The achievement ratio in group B was all better than group A and C(all P<0.05).In the aspect of pain tolerance,significant difference was shown between group A and C(P<0.05),while no statistical significance found in group B(P>0.05).Conclusion Holding the flexible tube 1 cm from the needle handle could raise the achievement ratio,decrease needle-related pain and reduce the requirement of seniority.