改良式定点穿刺在维持性血液透析患者中的应用

Application of Modified Fixed-point Puncture in Maintenance Hemodialysis Patients

目的:探究改良式定点穿刺在维持性血液透析患者中的应用情况。方法:选取2017年12月-2018年12月本院收治的83例维持性血液透析患者,依据随机数字表法将其分为对照组41例和观察组42例。对照组采用常规定点穿刺,观察组采用改良式定点穿刺。比较两组患者的穿刺情况、穿刺并发症的发生情况。结果:观察组患者穿刺成功率为99.32%,高于对照组的98.33%,差异有统计学意义(P<0.05)。观察组1年后穿刺时的疼痛评分明显低于对照组,差异有统计学意义(P<0.05)。开瘘1个月及1年后,两组穿刺血管内径、内瘘血液流速比较,差异均无统计学意义(P>0.05)。观察组穿刺后渗血发生率为4.75%,低于对照组的21.93%,差异有统计学意义(P<0.05)。观察组患者穿刺后感染、皮下血肿和动脉瘤发生率均明显低于对照组,差异均有统计学意义(P<0.05)。结论:改良式定点穿刺可以有效提高维持性透析患者穿刺成功率,降低疼痛程度,减少渗血、内瘘感染、皮下血肿等并发症的发生情况,且通过开瘘1个月及1年后血管内径值对比,并不会造成内瘘狭窄从而导致血流减少。

Objective:To explore the application of modified fixed-point puncture in maintenance hemodialysis patients.Method:A total of 83 patients with maintenance hemodialysis admitted to our hospital from December 2017 to December 2018 were selected.According to the random number table method,they were divided into control group 41 cases and observation group 42 cases.Conventional fixed-point puncture was used in the control group,and modified fixed-point puncture was used in the observation group.The puncture conditions and the incidence of puncture complications were compared between the two groups.Result:The puncture success rate in the observation group was 99.32%,higher than 98.33% in the control group,the difference was statistically significant (P<0.05).The pain score at puncture 1 year later in the observation group was significantly lower than that in the control group,the difference was statistically significant (P<0.05).Comparison of puncture vessel diameter and fistula blood flow rate between the two groups 1 month and 1 year after fistula opening,the differences were not statistically significant (P>0.05).The incidence of infiltration in the observation group was 4.75%,lower than 21.93% in the control group,the difference was statistically significant (P<0.05).The incidence of post-puncture infection,subcutaneous hematoma and aneurysm in the observation group were significantly lower than those in the control group,the differences were statistically significant (P<0.05).Conclusion:The modified fixed-point puncture can effectively improve the success rate of puncture,reduce the degree of pain,reduce the incidence of complications such as blood leakage,internal fistula infection,subcutaneous hematoma,and through the comparison of the internal diameter of blood vessels after 1 month and 1 year after opening the fistula,it will not cause the complications of reduced blood flow caused by stenosis of internal fistula.