蝶形固定在动静脉内瘘穿刺中的应用研究

Study on application of butterfly fixation in the puncture of internal arteriovenous fistula

目的探讨蝶形固定在动静脉内瘘穿刺中的应用效果。方法选取2022年1月至2023年1月于景德镇市第三人民医院行血液透析的100例动静脉内瘘患者作为研究对象,按照随机数字表法分为观察组与对照组,每组50例。观察组采用蝶形穿刺针固定,对照组采用横向穿刺针固定。比较两组一次穿刺成功率、穿刺疼痛程度、内瘘穿刺针滑脱情况、血路管固定相关事件发生情况、透析血流量、静脉压及尿素清除指数(KT/V)及并发症发生情况。结果观察组一次穿刺成功率高于对照组,穿刺疼痛程度轻于对照组,差异有统计学意义(P<0.05)。观察组胶布松脱、穿刺针半脱出与穿刺针完全脱出率均低于对照组,差异有统计学意义(P<0.05)。观察组血路管固定过程中打折发生率低于对照组,差异有统计学意义(P<0.05);两组拉拽、重力下滑发生率比较差异无统计学意义。观察组透析血流量高于对照组,差异有统计学意义(P<0.05);两组静脉压、KT/V比较差异无统计学意义。观察组并发症发生率低于对照组,差异有统计学意义(P<0.05)。观察组总满意度高于对照组,差异有统计学意义(P<0.05)。结论蝶形固定能有效提升血液透析患者动静脉内瘘穿刺成功率并降低穿刺疼痛,有效防止穿刺针滑脱,减少血路管固定相关事件和并发症的发生,增加患者透析血流量,提高患者满意度。

Objective To explore the effect of butterfly fixation in the puncture of internal arteriovenous fistula.Methods 100 patients with arteriovenous fistula undergoing hemodialysis were admitted to the Third People's Hospital of Jingdezhen,Jiangxi Province from January 2022 to January 2023 was selected as the study subjects,and they were divided into the observation group and the control group according to the method of random number table,with 50 cases in each group.The observation group was fixed with butterfly puncture needle,and the control group was fixed with transverse puncture needle.The success rate of puncture,the degree of puncture pain,the slip of the puncture needle of internal fistula,the occurrence of events related to the fixation of blood tube,the level of dialysis blood flow,venous pressure and urea clearance index(KT/V)and the complications were compared between the two groups.Results The success rate of puncture in the observation group was higher than that in the control group,and the degree of puncture pain was less than that in the control group,the differences were statistically significant(P<0.05).The rates of tape loosening,puncture needle semi-prolapse and puncture needle complete prolapse in the observation group were lower than those in the control group,and the differences were statistically significant(P<0.05).The discounting rate in the observation group was lower than that in the control group,the difference was statistically significant(P<0.05).There were no significant differences in the incidence of drag and gravity slide between the two groups.The dialysis blood flow in the observation group was higher than that in the control group,and the difference was statistically significant(P<0.05).There were no significant differences in venous pressure and KT/V between the two groups.The incidence of complications in the observation group was lower than that in the control group,and the difference was statistically significant(P<0.05).The total satisfaction in the observation group was higher than that in the control group,the difference was statistically significant(P<0.05).Conclusion Butterfly fixation can effectively improve the success rate of puncture of arteriovenous fistula in hemodialysis patients and reduce the puncture pain,effectively prevent the puncture needle from slipping,reduce the occurrence of events related to blood tube fixation and complications,increase the dialysis blood flow of patients,and improve the level of patient satisfaction.