关键词: 超声实时引导, 疑难动静脉内瘘, 血液透析, 专家共识

Abstract:

Objective To formulate an expert consensus on the puncture of difficult arteriovenous fistula under real-time guidance of ultrasound（hereinafter referred to as the consensus）. To standardize the clinical practice of ultrasound-guided puncture of difficult autologous arteriovenous fistula. Methods We conducted a comprehensive literature review of domestic and international publications，integrated clinical nursing experts’ practical experience，and followed evidence-based nursing principles to identify the best available evidence. Through expert panel discussions and 3 rounds of Delphi expert consultation，we systematically revised，refined and improved the initial draft of the consensus，ultimately developing the finalized version. Results The response rates of the 3 rounds of Delphi expert correspondence inquiries were all 100%；the authority coefficient of expert correspondence inquiries was 0.97；the mean importance assignment of the 3 rounds of correspondence inquiries was more than 3.50. The Kendall coordination coefficients of the 3 rounds of expert consultation were 0.127，0.120，and 0.201，respectively （P<0.05），and the degree of coordination of expert opinions was good and the expert opinions were consistent. The consensus summarized 5 aspects，including relevant terms and definitions，indications for real-time ultrasound-guided arteriovenous fistula puncture，personnel qualifications and training，difficult arteriovenous fistula puncture procedures under real-time ultrasound-guided，and nursing quality control. Conclusion The consensus is scientific，which can provide a basis for hemodialysis practitioners to practice the puncture of difficult arteriovenous fistula under real-time guidance of ultrasound.

Key words: Point-of-Care Ultrasound, Difficult Cannulation of Arteriovenous Fistula, Hemodialysis, Expert Consensus