糖尿病肾病血液透析患者动静脉内瘘的护理措施探讨

Study on Nursing Measures of Internal Arteriovenous Fistula of Patients with Hemodialysis of Diabetic Nephropathy

目的探讨总结糖尿病肾病血液透析病患动静脉内瘘的专项护理措施。方法选择2014年2月—2016年11月间在该院接受动静脉造瘘手术、血液透析治疗的糖尿病肾病患者42例,利用随机数表法将其分为两组,每组21例;观察组针对动静脉内瘘特点进行专项护理,对照组给予常规护理;两组观察期均为1年,对比两组护理满意度及动静脉内瘘状况。结果 (1)观察组动静脉内瘘成熟的平均时间为(7.12±1.17)周,明显少于对照组(8.09±1.04)周(P<0.05);(2)术后1年内,两组内瘘造瘘常见并发症包括内瘘穿刺点皮肤感染、内瘘血栓、内瘘血肿等,观察组内瘘并发症发生率为4.76%,显著低于对照组19.05%(P<0.05);(3)观察组患者对于动静脉内瘘护理的满意度为95.24%,明显高于对照组76.19%(P<0.05)。结论针对糖尿病肾病患者血液透析动静脉造瘘特点,采取专项护理措施,有助于预防造瘘并发症,促进内瘘成熟,提高护理满意度。

Objective To study the nursing measures of internal arteriovenous fistula of patients with hemodialysis of diabetic nephropathy. Methods 42 cases of diabetic nephropathy patients for artificial arteriovenous fistula surgery and hemodialysis in our hospital from February 2014 to November 2016 were selected and randomly divided into two groups with 21 cases in each, the observation group conducted the specific nursing according to the features of internal arteriovenous fistula, while the control group used the routine nursing, and the observation period was 1 year, and the nursing satisfactory degree and status of internal arteriovenous fistula were compared between the two groups. Results The average time of internal arteriovenous fistula maturation in the observation group was obviously lower than that in the control group, [（7.12±1.17） weeks vs（8.09±1.04） weeks]（P〈0.05）, and the common complications of internal arteriovenous fistula were the skin infection at the fistula puncture point, fistula thrombus and fistula hematoma, and the incidence rate of fistula complications in the observation group was obviously lower than that in the control group,（4.76%vs 19.05%）（P〈0.05）, and the nursing satisfactory degree of internal arteriovenous fistula in the observation group was obviously higher than that in the control group,（95.24% vs 76.19%）（P〈0.05）. Conclusion The specific nursing measures of internal arteriovenous fistula of patients with hemodialysis of diabetic nephropathy contribute to preventing the fistula complications, promote the fistula maturation and improve the nursing satisfactory degree.