倾向性护理在疑难动静脉内瘘穿刺中的应用

Application of propensity nursing in puncture of difficult arteriovenous fistula

目的探讨倾向性护理在疑难动静脉内瘘穿刺中的应用效果。方法选取2019年10月—2021年10月在河南科技大学第一附属医院进行维持性血液透析治疗的88例终末期肾病患者作为研究对象,采用随机信封法分为研究组与对照组,每组44例。2组患者均给予扣眼穿刺,透析时间为3个月。对照组患者在透析期间给予常规护理干预,研究组患者在对照组基础上给予倾向性护理干预。比较2组患者干预期间并发症发生情况;比较2组患者治疗效果;比较干预前及干预后(干预3个月后)2组患者内瘘血流速度与自我管理能力。结果研究组患者的治疗总有效率为97.73%(43/44),高于对照组的81.82%(36/44),差异有统计学意义(χ^(2)=4.456,P=0.035)。研究组患者护理干预期间并发症发生率为4.55%(2/44),低于对照组的22.73%(10/44),差异有统计学意义(χ^(2)=6.175,P=0.013)。2组患者干预前内瘘血流速度及静脉压比较,差异无统计学意义(P>0.05);2组患者干预后内瘘血流速度高于干预前且研究组高于对照组,静脉压低于干预前且研究组低于对照组,差异均有统计学意义(P<0.05)。2组患者干预前自我管理能力评分比较,差异均无统计学意义(P>0.05);2组患者干预后自我管理能力评分均高于干预前,且研究组高于对照组,差异均有统计学意义(P<0.05)。结论倾向性护理在疑难动静脉内瘘穿刺中应用,有助于降低并发症的发生风险,提高患者的治疗总有效率,还可改善内瘘的微循环状况,提高患者的自我管理能力。

Objective This paper aims to explore the effect of propensity nursing in the puncture of difficult arteriovenous fis-tula cases.Methods Eighty-eight patients with end-stage renal disease who underwent maintenance hemodialysis in the First Affiliated Hospital of Henan University of Science and Technology from October 2019 to October 2021 were selected as the study participant.They were assigned to the study group and the control group by the random envelope method,with 44 cases in each group.Buttonhole puncture was performed in both groups during 3 months of dialysis.Patients in the control group received routine nursing intervention during dialysis;patients in the study group,propensity nursing intervention based on the control group.Complication and treatment effect were compared between the two groups.The fistula blood flow velocity and self-management ability were compared before and after intervention(After 3 months of intervention).Re-sults The overall response rate of the study group was 97.73%(43/44),which was significantly higher than that of the control group[81.82%(36/44);χ^(2)=4.456,P=0.035].The incidence rate of complications during the nursing interven-tion in the study group was 4.55%(2/44),which was significantly lower than that in the control group[22.73%(10/44);χ^(2)=6.175,P=0.013].There were no significant differences in fistula blood flow velocity and venous pressure before in-tervention between the two groups(P>0.05).Fistula blood flow velocity after intervention in the two groups was in-creased,and the study group was higher than that in the control group;venous pressure after intervention in the two groups declined,and the study group was lower than that in the control group,all with statistical significance(P<0.05).There were no significant differences in the self-management ability scores before intervention between the 2 groups(P>0.05).The self-management ability scores after intervention in the 2 groups were raised,and the study group was higher than the control group,with statistical significance(P<0.05).Conclusion The application of propensity nursing in the puncture of difficult arteriovenous fistula cases is conducive to reducing the risk of complications,improving the overall response rate of treatment,enhancing the microcirculation of the fistula,and expanding the self-management ability of patients.