Chinese Journal of Nursing ›› 2020, Vol. 55 ›› Issue (5): 727-730.DOI: 10.3761/j.issn.0254-1769.2020.05.0019

• Specialist Practice and Research • Previous Articles     Next Articles

Application of zero-pressure modified puncture technique in hemodialysis patients with difficult arteriovenous fistula

HONG Chengbo,JIANG Rui,LING Kourong,JIANG Weizhong,XIONG Weilü   

  • Received:2019-05-08 Online:2020-05-15 Published:2020-05-08

疑难内瘘患者穿刺方法的改良及应用

洪成波,江瑞,凌扣荣,江伟忠,熊伟律   

  1. 313000 浙江省 湖州市中心医院血透中心"洪成波,江瑞,凌 扣荣,江伟忠,超声科(熊伟律
  • 作者简介:洪成波:男,本科,主管护师,E-mail :hong. chengbo@163.com
  • 基金资助:
    湖州市科技局项目(2018XYB09)

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

摘要:

目的 探讨零压力改良穿刺法在疑难内瘘患者穿刺中的应用效果。 方法 选取2014年1月—2016年4月某三级甲等医院血液透析中心126例疑难内瘘患者,随机分成试验组(64例)和对照组(62例),试验组采用零压力改良穿刺法,对照组采用常规穿刺方法,比较两组的一次性穿刺成功率,随访患者36个月内瘘相关并发症的发生情况,进行Kaplan-Meier生存曲线分析。 结果 试验组的一次性穿刺成功率高于对照组(P<0.01);试验组内瘘相关并发症发生率低于对照组(P<0.01);试验组并发症发生时间为(21.42±11.37)个月,晚于对照组(14.71±9.18)个月,差异有统计学意义(P<0.01)。 结论 零压力改良穿刺法能提高疑难内瘘一次性穿刺成功率,减少疑难内瘘相关并发症,推迟动静脉内瘘相关并发症发生时间。

关键词: 肾透析, 动静脉内瘘, 疑难穿刺, 并发症, 护理