钝针扣眼穿刺技术在自体动静脉内瘘血液透析中的应用

Application of blunt needle buttonhole cannulation technique in hemodialysis through autogenous arteriovenous fistula

目的:探讨钝针扣眼穿刺技术在自体动静脉内瘘血液透析患者中的应用价值。方法:根据数字表法将血透室60例血液透析患者随机分为钝针扣眼穿刺法(A组)和绳梯穿刺法(B组),每组30例,观察两组患者透析时穿刺VAS、拔针后按压时间、穿刺部位感染发生率、透析6个月后动脉血管瘤、血管狭窄发生率,透析时需中转其他穿刺法或其他血管的比例。结果:A组患者的穿刺VAS低于B组,拔针后按压时间少于B组(P<0.05);A组患者的穿刺部位感染、血管瘤和血管狭窄发生率与B组类似(P>0.05);A组患者的透析期间穿刺均成功,B组患者的有4例需中转至其他穿刺法或血管,两组差异有统计学意义(P<0.05)。结论:钝针扣眼穿刺法可减轻透析穿刺时疼痛,拔针后按压时间缩短;穿刺部位感染、血管瘤及血管狭窄发生率与绳梯法类似,且透析期间需中转至其他穿刺法或血管的比例较绳梯法低,故此穿刺技术安全可靠,值得在临床实践中推广使用。

Objective:To evaluate the value of blunt needle buttonhole cannulation technique in hemodialysis through autogenous arteriovenous fistula.Methods:60 patients in hemodialysis department were divided into group A(blunt needle buttonhole)and group B(rope-ladder),with 30 patients in each group.The puncture-induced VAS,compression time following dialysis,ratio of infection of puncture site,aneurysm and vascular stenosis,as well as the number of patients who need switch to other puncture technique or vascular were all observed.Results:the puncture induced VAS and the compression time following dialysis of group A were lower than those of group B(P<0.05);while there were no significant differences of the ratio of infection of puncture site,aneurysm and vascular stenosis between the two groups(P>0.05);in addition,all the patients in group A received blunt needle buttonhole technique,however,4 patients in group B need switch to other puncture technique or vascular during dialysis(P<0.05).Conclusion:the blunt needle buttonhole technique can release the puncture-induced VAS,reduce the compression time following dialysis,increase the successful puncturing ratio,and no increase on the ratio of infection of puncture site,aneurysm and vascular stenosis were observed,thus,this puncture technique is safe and worthy using in clinical practice.