新瘘拔针后指压止血的效果及对内瘘并发症的影响

Effect of finger pressure on hemostasis for new fistula after needle extraction and complications of internal fistula

目的探讨新瘘拔针后指压止血的效果及对内瘘并发症的影响。方法将行维持性血液透析治疗使用新瘘的患者104例随机分为观察组和对照组,各52例。在下机拔针后,对照组在下机常规拔针后,立即用弹力绷带止血;观察组由护士指压止血10 min后,再用弹力绷带固定纱球。比较两组压迫止血时间、出血量、内瘘并发症发生率及患者治疗满意度与舒适度。结果观察组压迫止血时间短于对照组,出血量少于对照组(P <0.05);观察组内瘘并发症发生率低于对照组(P <0.05);观察组舒适度与治疗满意度评分高于对照组(P <0.05)。结论新瘘穿刺拔针后,用指压止血10 min可减少针眼出血,缩短止血时间,降低内瘘并发症风险,更好地保护动静脉内瘘,延长内瘘使用寿命,提高患者治疗满意度及舒适度。

Objective To explore the effect of finger pressure on hemostasis for new fistula after needle extraction and the influence on complications of internal fistula. Methods A total of 104 patients with new fistula treated by maintenance hemodialysis were randomly divided into an observation group and a control group(n=52, respectively). After machine-based needle extraction, the control group used elastic bandage to stop bleeding immediately after routine needle extraction;the observation group used elastic bandage to fix the gauze ball after 10 minutes of hemostasis by nurses’ finger pressure. The compression hemostasis time, bleeding volume, incidence of complications of internal fistula and patients’ satisfaction and comfort with the treatment were compared between the two groups. Results The compression hemostasis time of the observation group was shorter than that of the control group, and the amount of bleeding was less than that of the control group(P < 0.05);the incidence of complications of internal fistula in the observation group was lower than that of the control group(P < 0.05), and the comfort and treatment satisfaction score of the observation group was higher than that of the control group(P < 0.05). Conclusion After puncturing and needle extraction for a new fistula, finger pressure for 10 minutes can stop bleeding can reduce bleeding from the puncturing site, shorten the time of hemostasis,reduce the risk of complications of internal fistula, better protect arteriovenous fistula, prolong the life of internal fistula, and improve patients’ satisfaction and comfort in treatment.