506所血液透析中心自体动静脉内瘘功能监测现状及障碍因素研究

doi:10.3761/j.issn.0254-1769.2024.24.003

摘要/Abstract

摘要：

目的调查血液透析中心自体动静脉内瘘（autogenous arteriovenous fistula，AVF）功能监测现状及障碍因素。方法采用便利抽样法，于2022年3月—4月，基于文献设计AVF功能不良情况的调查问卷，包括监测流程和制度、监测方法和内容、监测团队建设3个方面，共12个条目，调查527所血液透析中心AVF功能监测的执行情况，并分析主要障碍因素。结果有效回收调查问卷506份，有效问卷回收率为96.02%。506所血液透析中心AVF功能监测12个条目的执行率为12.65%~79.84%，总体得分为（4.97±3.03）分。全国6个行政区域在监测流程和制度、监测方法和内容、监测团队建设3个方面的条目执行得分以及总得分比较，差异均具有统计学意义（P<0.001）。相关障碍因素主要集中在管理制度、人力资源配置、专业培训以及医疗费用等方面。结论医院管理者应根据不同血液透析中心规模和实际情况，建立和完善相关管理制度，加强对AVF功能监测的监督以及监测方案的个性化管理，并推动血管通路多学科合作模式的开展。

关键词: 血液透析, 自体动静脉内瘘, 监测, 障碍因素, 护理

Abstract:

Objective To investigate the practice and barriers to functional monitoring of autogenous arteriovenous fistula（AVF） in hemodialysis centers in China. Methods Using convenience sampling，from March to April 2022，a questionnaire was designed based on the literature of AVF functional monitoring，and a total of 527 hemodialysis centers in China were investigated from 3 aspects，including monitoring process and system，monitoring method and content，and monitoring team construction. Results 506 questionnaires were effectively recovered，with a recovery rate of 96.02%. The implementation rate of the 12 entries of AVF functional monitoring ranged from 12.65%~79.84%，with an overall score of（4.97±3.03）. The scores had statistically significant differences in 6 administrative regions of China in monitoring process and system，monitoring method and content，and monitoring team building，as well as the total scores（P<0.001）. Barriers were centered on management specification，human resource allocation，professional training，and healthcare costs. Conclusion Hospital administrators should construct and perfect the relevant management system according to the scale and actual situation of different hemodialysis centers，strengthen the supervision of AVF functional monitoring as well as the personalised management of monitoring protocols，and promote the development of a multidisciplinary cooperation model for vascular access.

Key words: Hemodialysis, Autogenous Arteriovenous Fistula, Monitoring, Barrier, Nursing Care

刘瑶, 李静, 曹立云, 郑茜子, 王晋伟, 向晶, 苏默, 李纯, 刘雨佳, 王志稳. 506所血液透析中心自体动静脉内瘘功能监测现状及障碍因素研究[J]. 中华护理杂志, 2024, 59(24): 2966-2972.

LIU Yao, LI Jing, CAO Liyun, ZHENG Xizi, WANG Jinwei, XIANG Jing, SU Mo, LI Chun, LIU Yujia, WANG Zhiwen. Status and barriers to functional monitoring of autogenous arteriovenous fistula in 506 hemodialysis centers[J]. Chinese Journal of Nursing, 2024, 59(24): 2966-2972.

图/表 3

表1 506所血液透析中心自体动静脉内瘘功能监测总体执行现状[所（百分比，%）]

Table 1 Overall status of functional monitoring of AVF in 506 hemodialysis centers[center（percentage,%）]

表2 不同地区自体动静脉内瘘功能监测的执行现状比较[分，（$\bar{x}±s$）]

Table 2 Comparison of functional monitoring of AVF in different regions[score，（$\bar{x}±s$）]

表3 自体动静脉内瘘功能监测的障碍因素（n=506）

Table 3 Barriers to functional monitoring of AVF（n=506）

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