老年患者维持性血液透析钝针扣眼穿刺的应用及护理

The application and nursing of blunt needle buttonhole puncture in elderly maintenance hemodialysis patients

目的分析老年患者维持性血液透析钝针扣眼穿刺的应用及护理效果。方法选择株洲市中心医院收治的实施维持性血液透析治疗的老年患者83例为观察对象(2016年2月至2017年12月),针对老年患者实施维持性血液透析钝针扣眼穿刺治疗,随机分成2组,针对常规组41例老年患者实施常规护理,针对治疗组42例老年患者实施系统性护理,分析对比两组老年患者的护理效果。结果治疗组老年患者护理后的内瘘穿刺并发症发生率(7.14%)明显低于常规组老年患者(24.39%),2组相比:χ~2值=4.6721,P=0.031;治疗组老年患者护理后的钝针扣眼穿刺成功率(97.62%)明显高于常规组老年患者(85.37%),两组相比:χ~2值=4.0337,P=0.045;常规组老年患者与治疗组老年患者之间对比的满意度评分(t值=10.1670,P值<0.001)、疼痛评分(t值=6.6296,P值<0.001)存在较为显著的差异,差异有统计学意义。结论针对实施维持性血液透析治疗的老年患者给予钝针扣眼穿刺及系统性护理的效果较为显著,减轻患者的痛苦。

Objective To analyze the application and nursing of blunt needle buttonhole puncture in elderly maintenance hemodialysis（MHD） patients. Methods We recruited 83 elderly MHD patients treated in this hospital during Feb. 2016 to Dec. 2017. Blunt needle buttonhole puncture was used for blood access, and the patients were divided into conventional nursing group（n=41） and specific nursing group（n=42）, in which systematic nursing suitable for elderly MHD patients was used. Nursing effects were compared between the two groups. Results The prevalence of puncture complications were lower in the specific nursing group than in the conventional nursing group（7.14% vs. 24.39%, χ^2=4.6721, P=0.031）. The success rate of blunt needle buttonhole puncture was higher in the specific nursing group than in the conventional nursing group（97.62%vs. 85.37%,χ^2=4.0337, P=0.045）. The satisfaction scores and pain scores from elderly MHD patients were statistically different between the two groups（P〈0.05）. Conclusion The systematic nursing specific for blunt needle buttonhole puncture was effective and alleviated pain sensation in elderly MHD patients.