改良绳梯式与传统区域穿刺法对长期血液透析患者内瘘皮肤瘢痕及内瘘使用功能状态的影响

Effects of modified rope ladder puncture versus traditional regional puncture on skin scarring after internal fistula and the functional status of internal fistula in long-term hemodialysis patients

目的探讨改良绳梯式与传统区域穿刺法对长期血液透析患者内瘘皮肤瘢痕及内瘘使用功能状态的影响。方法选取广西壮族自治区桂东人民医院2020年1月至2021年1月收治80例血液透析患者进行研究,按照随机抽签法分为对照组与观察组,对照组选用区域穿刺法建立血液透析血管通道,观察组选用改良绳梯式穿刺法,比较两组的穿刺效果、并发症总发生率与穿刺满意度。结果观察组穿刺成功率、血流量充足率高于对照组,差异有统计学意义(P<0.05);观察组内瘘皮肤瘢痕率低于对照组,差异有统计学意义(P<0.05);观察组并发症总发生率低于对照组,差异有统计学意义(P<0.05);观察组穿刺总满意率高于对照组,差异有统计学意义(P<0.05)。结论应用改良绳梯式穿刺法建立血液透析血管通道的效果优于传统区域穿刺法,穿刺成功率更高,血液透析血流量更加充足,内瘘皮肤瘢痕率更低,能减少并发症,利于血液透析治疗,值得推广应用。

Objective To investigate the effects of modified rope ladder puncture versus traditional regional puncture on skin scarring after internal fistula and the functional status of internal fistula in long-term hemodialysis patients.Methods A total of 80 hemodialysis patients admitted to Guidong People’s Hospital of Guangxi Zhuang Autonomous Region from January 2020 to January 2021 were selected as study subjects and divided into the control group and the observation group according to the random drawing method.The control group received the regional puncture and the observation group received the modified rope ladder puncture to establish the vascular access for hemodialysis.The puncture effect,the complication rate and the satisfaction of patients with puncture were compared between the two groups.Results The rates of success puncture and adequate blood flow in the observation group were higher than those in the control group,with statistically significant differences(P<0.05).the skin scar rate of internal fistula in the observation group was lower than that in the control group,with statistically significant differences(P<0.05).The overall complication rate in the observation group was lower than that in the control group,with statistically significant differences(P<0.05).The overall satisfaction rate of patients with puncture in the observation group was higher than that in the control group,with statistically significant differences(P<0.05).Conclusion The modified rope ladder puncture is better than the traditional regional puncture in es tablishing vascular access for hemodialysis,and the former has a higher success rate of puncture,more adequate blood flow during hemodialysis and lower skin scarring rate after internal fistula,and can reduce com plications and facilitate hemodialysis treatment,which is worthy of promotion.