较粗静脉穿刺引血在内瘘穿刺引血困难中的运用

Application of larger vein puncture and bleeding drainage in difficult puncture and bleeding drainage of internal fistula

目的探讨较粗静脉穿刺在内瘘穿刺引血困难中的运用效果。方法选取2017年10月~2018年10月在我院行血液透析治疗过程中出现内瘘穿刺引血困难的48例患者作为研究对象,应用随机数字表法均分为研究组和对照组,各24例。其中对照组患者应用传统法进行处理,研究组患者应用较粗静脉穿刺进行处理。比较两组患者处理后的血液透析流量、透析等待时间和穿刺成功率、操作误伤率及并发症发生情况。结果研究组患者的血液透析流量和穿刺成功率明显高于对照组,透析等待时间明显短于对照组,操作误伤率明显低于对照组,差异有统计学意义(P<0.05)。研究组患者处理后的并发症总发生率为4.17%,明显低于对照组的29.17%,差异有统计学意义(P<0.05)。结论较粗静脉血管穿刺引血在内瘘穿刺引血困难中的应急运用可以缩短透析等待时间,降低操作误伤率和并发症发生率,提高血液透析流量和穿刺成功率,便于医护人员操作,保证维持性血液透析患者治疗的及时性。

Objective to explore the application effect of larger vein puncture and bleeding drainage in difficult puncture and bleeding drainage of internal fistula.Methods All of 48 patients with difficulty in puncture and bleeding drainage of internal fistula during hemodialysis treatment in our hospital from October 2017 to October 2018 were selected as the study subjects.All of them were divided into the research group and the control group by using the random number table method,with 24 cases in each group.Patients in the control group were treated with traditional method,while those in the study group were treated with larger vein puncture.The flow of hemodialysis,waiting time for hemodialysis,puncture success rate,operational miscarriage rate and the incidence of complications were compared in patients between the two groups.Results The flow of hemodialysis and puncture success rate of the study group were significantly higher than those of the control group,and the waiting time for hemodialysis was significantly shorter than that of the control group,operational miscarriage rate was significantly lower than that of the control group,with statistically significant differences(P<0.05).The total incidence of complications was 4.17%in the study group,which was significantly lower than that of the control group(29.17%),with statistically significant difference(P<0.05).Conclusion The emergency application of larger vein puncture and bleeding drainage in difficult puncture and bleeding drainage of internal fistula can shorten the waiting time for hemodialysis,reduce the operational miscarriage rate and the incidence of complications,improve the flow of hemodialysis and the success rate of puncture,facilitate the operation of medical staff and ensure the timeliness of treatment for patients with maintenance hemodialysis.