远红外线联合钝针扣眼穿刺法治疗对血液透析患者动静脉内瘘保护作用分析

The protective effect of far-infrared rays combined with blunt needle buttonhole technique in the treatment of internal arteriovenous fistula in patients undergoing hemodialysis

目的分析远红外线联合钝针扣眼穿刺法对血液透析患者动静脉内瘘的保护作用。方法选取2014年11月至2017年2月我院维持性血液透析患者160例,随机将其分为试验组(n=80)、对照组(n=80),对照组给予远红外线治疗结合传统区域锐针穿刺法进行穿刺,试验组行远红外线治疗结合钝针扣眼穿刺法进行穿刺,评价两组患者一次穿刺成功率、穿刺部位渗血率、拔针按压时间、穿刺时疼痛度及治疗前后动脉瘤最大横径、头静脉壁厚、血流量变化、治疗后6个月并发症发生率。结果试验组一次穿刺成功率97. 50%与对照组88. 75%比较差异有统计学意义(P <0. 05),试验组穿刺部位渗血率、拔针按压时间、疼痛度、并发症发生率低/短于对照组(P <0. 05);治疗后6个月试验组动脉瘤最大横径、头静脉壁厚较对照组小,试验组血流量较对照组高(P <0. 05)。结论远红外线结合钝针扣眼穿刺法穿刺对维持性血液透析患者动静脉内瘘有较好保护作用,可提高一次穿刺成功率,缩小动脉瘤横径,明显改善其局部血流,减少穿刺点渗血率、疼痛度及并发症,值得在临床推广实践。

To analyze the protective effect of far-infrared rays combined with blunt needle buttonhole technique in the treatment of internal arteriovenous fistula in patients undergoing hemodialysis.A total of 160 patients who underwent maintenance hemodialysis(MHD)in our hospital during the period from November 2014 to February 2017 were selected.They were randomly divided into the experimental group(n=80)and the control group(n=80).The control group was given far-infrared ray treatment combined with traditional regional sharp needle puncture while the experimental group was given far-infrared ray treatment combined with blunt needle buttonhole puncture.The one-time success rate of puncture,bleeding rate at puncture site,pressing time after needle withdrawal,pain at puncture site,changes in the maximum transverse diameter of aneurysm,wall thickness of the cephalic vein and blood flow before and after treatment and incidence of complications after 6 months of treatment were assessed.There was a significant difference in the one-time success rate of puncture between the two groups(97.50%vs 88.75%)(P<0.05).The bleeding rate at puncture site,the pressing time after needle withdrawal,the pain degree and the incidence of complications in the experimental group were lower or shorter than those in the control group(P<0.05).The maximum transverse diameter of the aneurysm and the wall thickness of the cephalic vein in the experimental group were smaller while the blood flow was higher than those in the control group after 6 months of treatment(P<0.05).Far-infrared rays combined with blunt needle buttonhole puncture can protect the patients undergoing hemodialysis from internal arteriovenous fistula.It can improve the one-time success rate of puncture,decrease the maximum transverse diameter of the aneurysm,obviously improve the local blood flow and decrease the bleeding rate and pain degree at puncture site as well as the incidence of complications.