关键词: 肾透析, 动静脉内瘘, 疑难穿刺, 并发症, 护理

Abstract:

Objective To explore the effects of zero-pressure modified puncture technique in hemodialysis patients with difficult arteriovenous fistula（AVF）. Methods The hemodialysis patients with difficult AVF at a hemodia-lysis center in a tertiary hospital from January 2014 to April 2016 were recruited and randomly allocated into an experimental group（n=64） and a control group（n=62）. The patients in the experimental group were punctured with the zero-pressure modified puncture technique,while the patients in the control group were punctured with routine method. The first-attempt success rate was compared between 2 groups. All patients were followed up for 36 months and relevant complications were recorded. Kaplan-Meier survival curve and log-rank test were conducted. Results The first-attempt success rate in the experimental group was significantly higher than that in the control group（P<0.01）;the incidence of the complications of AVF in the experimental group was significantly lower than that in the control group（P<0.01）;the duration without complication of AVF in the experimental group as（21.42±11.37） months was significantly longer than that in the control group as（14.71±9.18） months（P<0.01）. Conclusion For difficult AVF,zero-pressure modified puncture technique can increase first-attempt success rate,decrease complications of difficult AVF and significantly prolong the duration without complications.

Key words: Renal Dialysis, Arteriovenous Fistula, Difficult Puncture, Complications, Nursing Care