中华护理杂志 ›› 2025, Vol. 60 ›› Issue (22): 2693-2698.DOI: 10.3761/j.issn.0254-1769.2025.22.001

• 标准与规范 •    下一篇

内瘘软管针动静脉内瘘穿刺技术规范专家共识

中华护理学会血液净化护理专业委员会(执笔:杨振华 夏京华 吴霞珺 潘孝婷 陈秋馨 曹立云 肖光辉 黄碧红)   

  1. 200020 上海市 上海交通大学医学院附属瑞金医院肾脏科血液净化中心(杨振华,吴霞珺,潘孝婷,陈秋馨);中国医学科学院北京协和医院内科学系肾内科(夏京华);北京大学第一医院肾脏内科(曹立云);北京市海淀医院肾脏内科(肖光辉);复旦大学附属华山医院护理部(黄碧红)
  • 收稿日期:2025-05-27 出版日期:2025-11-20 发布日期:2025-11-13
  • 作者简介:杨振华:女,本科,副主任护师,护士长,E-mail:yzh20652@rjh.com.cn

Expert consensus on technical specifications for arteriovenous fistula puncture using fistula soft catheter needles

Blood Purification Committee of Chinese Nursing Association(Writing Committee:YANG Zhenhua,XIA Jinghua,WU Xiajun,PAN Xiaoting,CHEN Qiuxin,CAO Liyun,XIAO Guanghui,HUANG Bihong)   

  • Received:2025-05-27 Online:2025-11-20 Published:2025-11-13

摘要:

目的 形成内瘘软管针动静脉内瘘穿刺技术规范专家共识(以下简称“共识”),为规范内瘘软管针的操作方法提供参考。方法 查阅国内外内瘘软管针动静脉内瘘穿刺相关文献、结合血液净化专家工作经验,以循证护理为依据,寻找最佳证据,设计专家函询表,通过2轮专家函询和2轮专家论证会,对共识内容进行调整和修改。结果 共邀请17名专家参与函询。2轮专家函询有效问卷回收率均为100%,所有专家在函询过程中对相关问题提出了建议。2轮专家函询协调系数分别为0.507、0.524。此外,专家权威系数为0.99,表明专家函询权威程度较高。2轮变异系数均<0.15,表明专家判定的结果也相对一致。“共识”总结了内瘘软管针穿刺相关术语及定义、适用范围与禁忌证、人员资质与培训、穿刺前准备、穿刺前评估、穿刺实施、穿刺针固定、拔针、注意事项、用物处置10个主题内容。结论 “共识”具有较强的实用性和科学性,为内瘘软管针动静脉内瘘穿刺操作技术提供临床操作实践及教学指导,为促进内瘘软管针动静脉内瘘穿刺操作技术的规范开展提供参考。

关键词: 内瘘软管针, 动静脉内瘘, 穿刺, 护理, 专家共识

Abstract:

Objective To formulate an expert consensus on technical specifications for arteriovenous fistula puncture using fistula soft catheter needles(hereinafter referred to as the “Consensus”),providing references for standardizing the operation methods of fistula soft catheter needles for internal fistulas. Methods Domestic and international literature on arteriovenous fistula puncture using fistula soft catheter needles was reviewed,combined with the work experience of blood purification experts. Based on evidence-based nursing,the best evidence was identified,and expert consultation forms were designed. Through 2 rounds of Delphi expert consultation and expert panel discussions,the content of the consensus was adjusted and revised. Results A total of 17 experts were invited to participate in the consultation. All 17 questionnaires were eventually returned,achieving a 100% response rate. All experts provided suggestions on relevant issues during the consultation process. The coordination coefficients for the first and second rounds of expert consultations were 0.507 and 0.524,respectively,both of which were statistically significant. Additionally,the expert authority coefficient was 0.99,indicating a high level of authority in the expert consultation and credible results. The coefficient of variation for both the first and second rounds is less than 0.15,indicating that the expert’s judgment results are relatively consistent. The Consensus summarizes 10 main topics related to the terminology and definitions,scope of application and contraindications,personnel qualifications and training,pre-puncture preparation,pre-puncture evaluation,puncture implementation,puncture needle fixation,needle removal,operational precautions,and material handling of internal fistula soft needle puncture. Conclusion The Consensus has strong practicality and scientific validity,providing clinical operation practices and teaching guidance for the puncture operation technology of arteriovenous fistulas using fistula soft catheter needles,thereby promoting the standardized development of this technology.

Key words: Fistula Soft Catheter Needle, Arteriovenous Fistula, Puncture, Nursing Care, Expert Consensus