钝针扣眼穿刺法在预防维持性血液透析患者内瘘并发症的疗效观察

Efficacy of Blunt Needle Buttonhole Puncture on Prevention of Fistula-induced Complications in Patients with Maintenance Hemodialysis

目的探讨钝针扣眼穿刺法在预防维持性血液透析患者内瘘并发症的疗效。方法以我院80例血液透析患者为观察对象,根据随机数字表分为观察组与对照组,患者均予以自体动静脉内瘘作为血液透析通路,对照组采取传统锐针,观察组采取钝针扣眼穿刺法,比较两组内瘘穿刺成功率,并统计并发症发生率。结果两组一次穿刺成功率、穿刺点渗血及感染情况比较,差异无统计学意义(P>0.05),观察组VAS评分(3.4±0.8)分,显著低于对照组(3.8±0.7)分(P<0.05);观察组渗血、假性动脉瘤、皮下血肿发生率依次为15.0%、5.0%、22.5%,均显著低于27.5%、22.5%、45.0%(P<0.05),且两组均无血栓发生。结论维持性血液透析患者实施钝针扣眼穿刺法效果较佳,能有效减少内瘘并发症,值得临床推广。

Objective To explore the efficacy of blunt needle buttonhole puncture on prevention of fistula-induced complications in patients with maintenance hemodialysis.Methods 80 patients with hemodialysis in our hospital were selected as observation subjects.According to the random number table method,the patients were divided into observation group and control group.The patients were given autologous arteriovenous fistula as the hemodialysis channel,and control group was given traditional sharp needle,and observation group was given blunt needle buttonhole puncture.The success rate of fistula puncture was compared between the two groups and the incidence rate of complications was counted.Results There were no significant differences in the success rate of one-time puncture and errhysis and infection at puncture sites between the two groups(P>0.05).The VAS score in observation group was significantly lower than that in control group[(3.4±0.8)points vs(3.8±0.7)points](P<0.05).The incidence rates of errhysis,pseudoaneurysm and subcutaneous hematoma were 15.0%,5.0%and 22.5%respectively in observation group,which were significantly lower than those in control group with 27.5%,22.5%and 45.0%(P<0.05).And there was no thrombosis in the two groups.Conclusion Blunt needle buttonhole puncture has better effects on patients with maintenance hemodialysis,and it can effectively reduce the fistula-induced complications and it is worthy of clinical promotion.