自体动静脉内瘘患者应用导图穿刺的效果观察

目的探讨自体动静脉内瘘患者应用导图穿刺的效果。方法选取2022年2月至2022年8月首次以自体动静脉内瘘(AVF)为血管通路的透析患者40例。采用随机数字法分为对照组与观察组,每组各20例。对照组采用传统穿刺方法,观察组采用导图穿刺方法,比较2组患者6个月内穿刺成功率、护士执行绳梯穿刺依从率、内瘘并发症及Kt/V达标率情况。结果观察组中护士执行绳梯穿刺依从率及穿刺成功率高于对照组(P<0.001);观察组中出现渗血、穿刺处硬结发生率低于对照组(P<0.05);观察组局部血管明显扩张甚至隆起、血栓形成及血管狭窄发生率低于对照组(P<0.05),两组内瘘堵塞率比较差异无统计学意义(P>0.05);观察组患者Kt/V达标率高于对照组,差异有统计学意义(P<0.001)。结论导图穿刺应用于AVF患者中能够提高穿刺成功率及Kt/V达标率,降低内瘘并发症,延长内瘘使用寿命,提高患者透析质量。

Objective To investigate the effect of applying mapping puncture in patients with autogenous arteriovenous internal fistula(AVF).Methods 40 hemodialysis patients who underwent arteriovenous fistula(AVF)as the vascular access for the first time from February 2022 to August 2022 were selected.The patients were randomly divided into the control group and the observation group with 20 cases in each group.The traditional puncture method was used in the control group,and the map puncture method was used in the observation group,the puncture success rate within 6 months,the compliance rate of rope ladder puncture,fistula complications and KT/V compliance rate were compared between the two groups.Results The compliance rate and success rate of rope ladder puncture in the observation group were higher than those in the control group(P<0.001),and the incidences of bleeding and induration in the observation group were lower than those in the control group(P<0.05).The incidence of local vascular dilatation,thrombosis and stenosis in the observation group was lower than that in the control group(P<0.05),and there was no significant difference between the two groups(P>0.05).The rate of Kt/V in the observation group was higher than that in the control group(P<0.001).Conclusion The application of map puncture in AVF patients can improve the success rate of puncture and KT/V standard,reduce the complications of fistula,prolong the life of fistula and improve the quality of dialysis.