作　　者： (关宏）; (李海梅）; (王燕红）; (宗从明）; (黄蕾）;

机构地区： 江苏省太仓市中医医院血液净化中心,江苏太仓215400

出　　处： 《中西医结合护理（中英文）》 2017年第8期99-102,共4页

摘　　要： 目的比较维持性血液透析患者动静脉内瘘2种不同穿刺法的临床应用效果,总结相关护理措施。方法选取2015年1月—2017年4月进行维持性血液透析治疗的130例患者为研究对象,根据治疗期间穿刺方法的不同分为钝针组(n=30)和锐针组(n=100),2组均给予科学合理的护理干预措施,锐针组给予锐针绳梯穿刺法,钝针组施行钝针扣眼穿刺法。观察2组汉密尔顿焦虑(MAHA)量表和疼痛视觉模拟评分(VAS)量表及生活质量综合评定(GQOLI)量表评分。观察2组临床治疗及并发症发生情况。结果钝针组M AHA、VAS量表评分低于锐针组(P<0.05或P<0.01),GQOLI量表评分高于锐针组(P<0.01)。钝针组一次穿刺成功率高于锐针组(P<0.05),且渗血发生率低于锐针组(P<0.05)。钝针组内瘘相关并发症发生率低于锐针组(P<0.05)。结论维持性血液透析患者动静脉内瘘采用钝针扣眼穿刺法效果更确切,同时配合护理干预,能缓解患者紧张状态和疼痛程度,减少并发症的发生。 Objective To observe and compare the effect of two different puncture methods for arteriovenous fistula in maintenance hemodialysis patients,and summarize related the nursing measures. Methods A total of 130 patients undergoing maintenance hemodialysis were collected and divided into blunt needle group( n = 30) and sharp needle group( n = 100). The Hamilton rating scale for anxiety( MAHA),visual analog scale( VAS) and general quality of life inventory( GQOLI) were adopted,and the complication of arteriovenous fistula were observed and compared between two groups. Results The scores of MAHA and VAS scales were lower in the blunt needle group than those of sharp needle group( P < 0. 05 or P < 0. 01),and the GQOLI scale score in the blunt needle group was higher than that sharp needle group( P < 0. 01). The one-time success rate of puncture was higher in the blunt needle group than those of sharp needle group( P < 0. 05). The incidence of hemorrhage at puncture site and fistula-related complications were lower in the blunt needle group than those of sharp needle group( P < 0. 05). Conclusion Using blunt needle puncture method shows better efficacy in establishment of arteriovenous fistula.The nursing cooperative measures are also required to relieve the anxiety status of patients and reduce the risk of fistula-related complications.

关 键 词： 穿刺法 血液透析 动静脉内瘘 焦虑状态 钝针穿刺 并发症