细节优化定期维护干预对血液透析患者自体动静脉内瘘并发症发生率的影响

The Effect of Detail Optimization and Regular Maintenance Intervention on the Complication Rate of Autogenous Arteriovenous Fistula in Hemodialysis Patients

目的:分析细节优化定期维护干预对血液透析患者自体动静脉内瘘(AVF)并发症发生率的影响。方法:选取2018年1月-2019年10月本院收治的50例血液透析患者。根据干预方法不同分为对照组与观察组,每组25例。对照组予以常规护理干预,观察组予以细节优化定期维护干预联合常规护理。观察两组患者自体AVF并发症发生情况、内瘘闭塞发生率及动脉瘤样扩张率、护理满意率,比较两组自我护理能力及生活质量评分。结果:干预3个月,观察组AVF并发症发生率为4.00%,明显低于对照组的28.00%,差异均有统计学意义(P<0.05)。干预3个月,观察组的内瘘闭塞、动脉瘤样扩张发生率分别为8.00%、4.00%,均低于对照组的32.00%、24.00%,差异均有统计学意义(P<0.05)。干预3个月后,观察组自我护理能力评分、心理领域、环境领域、躯体领域、社会领域的评分及总分均高于对照组,差异均有统计学意义(P<0.05)。干预3个月后,观察组患者对注意事项指导、用药指导、内瘘日常宣教、服务态度、解决问题方面的满意率均高于对照组,差异均有统计学意义(P<0.05)。结论:将细节优化定期维护干预应用于血液透析患者,可有效降低AVF并发症发生率、内瘘闭塞发生率及动脉瘤样扩张率,提升其自我护理能力、生活质量和护理满意度。

Objective:To analyze the effect of detail optimization and regular maintenance intervention on the complication rate of autogenous arteriovenous fistula (AVF) in hemodialysis patients.Method:A total of 50 hemodialysis patients from January 2018 to October 2019 in our hospital were selected.According to different intervention methods,they were divided into control group and observation group,25 cases in each group.The control group was given routine nursing intervention,while the observation group was given detail optimization,regular maintenance intervention combined with routine nursing.The incidence of complications,incidence of internal fistula occlusion,aneurysm like dilatation rate and nursing satisfaction rate of patients in the two groups were observed.The self-care ability and quality of life scores of the two groups were compared.Result:After 3 months of intervention,the incidence of AVF complications in the observation group was 4.00%,significantly lower than 28.00% in the control group,with statistically significant differences (P<0.05).After 3 months of intervention,the incidence of internal fistula occlusion and aneurysmal dilatation in the observation group were 8.00% and 4.00%,which were lower than 32.00% and 24.00% of the control group,the differences were statistically significant (P<0.05).After 3 months of intervention,the score and total score of self-care ability,psychological field,environmental field,physical field and social field in the observation group were all higher than those in the control group,with statistically significant differences (P<0.05).After 3 months of intervention,the satisfaction rate of patients in the observation group were higher than those in the control group in terms of guidance of precautions,medication guidance,daily propaganda and education of internal fistula,service attitude and problem-solving,the differences were statistically significant (P<0.05).Conclusion:The application of detail optimized regular maintenance intervention to hemodialysis patients can effectively reduce the incidence of AVF complications,internal fistula occlusion rate and aneurysm like expansion rate,and improve their self-care ability,quality of life and nursing satisfaction.