钝针穿刺内瘘技术应用于血液透析患者的护理体会

Nursing experience on application of blunt needle puncture internal fistula technique in hemodialysis patients

目的探讨钝针穿刺内瘘技术应用于血液透析患者的护理效果。方法回顾性分析2017年3月~2019年2月于我院进行血液透析的100例患者资料,根据使用的穿刺法来将其分为绳梯法穿刺组(49例)、钝针穿刺组(51例),比较两组患者穿刺点渗血率、穿刺失败率、疼痛视觉模拟(VAS)评分、透析间血流量、拔针按压时间、并发症发生率以及护理满意度评分。结果经护理,钝针穿刺组的穿刺点渗血率与穿刺失败率均明显低于绳梯穿刺组,差异有统计学意义(P<0.05);钝针穿刺组的VAS评分明显低于绳梯穿刺组,差异有统计学意义(P<0.05);钝针穿刺组护理满意度评分明显高于绳梯穿刺组,差异有统计学意义(P<0.05);钝针穿刺组的拔针按压时间明显短于绳梯穿刺组,差异有统计学意义(P<0.05);两组的透析间血流量差异无统计学意义(P>0.05);钝针穿刺组的并发症发生率明显低于绳梯穿刺组,差异有统计学意义(P<0.05)。结论钝针穿刺内瘘技术在血液透析中的应用可以显著缓解患者治疗期间的疼痛情况,有效保护血管,提高血液透析的安全性,进而提高患者对护理的满意度,因此该护理方法具备临床推广价值。

Objective To explore nursing effects of application of blunt needle puncture internal fistula technique in hemodialysis patients. Methods 100 patients who underwent hemodialysis in our hospital from March 2017 to February 2019 were respectively selected as observation objects. According to puncture methods, they were divided into the rope ladder puncture group(49 cases) and the blunt needle puncture group(51 cases). The blood oozing rate of puncture point, puncture failure rate, visual analogue scale(VAS) score, blood flow during dialysis, needle extraction and compression time, complication rate and nursing satisfaction score of the two groups were compared. Results After nursing, blood oozing rate of puncture point and puncture failure rate of the blunt needle puncture group were both significantly lower than those of the rope ladder puncture group, and the difference was statistically significant(P< 0.05). VAS score of the blunt needle puncture group was significantly lower than that of the rope ladder puncture group, and the difference was statistically significant(P<0.05). Nursing satisfaction of blunt needle puncture group was significantly higher than that of the rope ladder puncture group, and the difference was statistically significant(P<0.05).The needle extraction and compression time of the blunt needle puncture group was significantly shorter than that of the rope ladder puncture group, and the difference was statistically significant(P<0.05). There was no statistically significant difference in blood flow during dialysis between the two groups(P>0.05). Complication rate of the blunt needle puncture group was significantly lower than that of the rope ladder puncture group, and the difference was statistically significant(P<0.05). Conclusion Application of blunt needle puncture internal fistula technique in hemodialysis patients can significantly alleviate the pain of patients during the treatment, effectively protect blood vessels, improve the safety of hemodialysis and thereby improve the nursing satisfaction of patients. Therefore, this nursing method has clinical promotion values.