内瘘血管穿刺示意图在血液透析AVF的应用效果评价
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摘要
目的探讨内瘘血管穿刺示意图在血液透析自体动静脉内瘘(AVF)穿刺的应用效果。方法 2017年6月开始实施内瘘血管穿刺示意图绘制,按示意图有规划、保护性的穿刺血管,提高血管穿刺部位轮换率。选择2016年5月～2017年5月(开展内瘘血管绘制活动前12个月)血液净化中心使用内瘘进行血液透析的158例患者为对照组。2017年7月～2018年7月(开展内瘘血管绘制活动后12个月)血液净化中心进行血液透析的162例患者为观察组。比较两组内瘘穿刺点渗血及并发症发生率、护理人员素质、患者满意度。结果观察组静脉内瘘穿刺点皮下渗血、并发症发生率低于对照组(P<0.05),护理人员素质评分、患者满意度高于对照组(P<0.05)。结论通过开展内瘘血管穿刺示意图绘制活动后,有效降低了患者内瘘穿刺点渗血及并发症的发生率,提高了护理人员的素质和患者满意度。
Objective To investigate the effect of arteriovenous fistula puncture schematic diagram on hemodialysis. Methods Schematic diagram for arteriovenous fistula puncture was applied from June in 2017,by which fistula vessel was punctured protectively and puncture point was alternate regularly.158 patients were distributed into the control group from May in 2016 to May in 2017 before schematic diagram was applied,162 patients were distributed into the observation group from July in 2017 to July in 2018 after schematic diagram applied, incidence of exudation from puncture point, incidence of fistula complication, scores of nursing quality, satisfaction index of patients were compared between two groups. Results incidence of exudation from puncture point and incidence of fistula complication were lower in the observation group than in the control group(P<0.05), scores of nursing quality and satisfaction index of patients were higher in the observation group than in the control group(P<0.05). Conclusion application of schematic diagram for arteriovenous fistula puncture,effectively decreases incidence of exudation from puncture point and incidence of fistula complication, improves nursing quality and satisfaction of patients.
Objective To investigate the effect of arteriovenous fistula puncture schematic diagram on hemodialysis. Methods Schematic diagram for arteriovenous fistula puncture was applied from June in 2017,by which fistula vessel was punctured protectively and puncture point was alternate regularly.158 patients were distributed into the control group from May in 2016 to May in 2017 before schematic diagram was applied,162 patients were distributed into the observation group from July in 2017 to July in 2018 after schematic diagram applied, incidence of exudation from puncture point, incidence of fistula complication, scores of nursing quality, satisfaction index of patients were compared between two groups. Results incidence of exudation from puncture point and incidence of fistula complication were lower in the observation group than in the control group(P<0.05), scores of nursing quality and satisfaction index of patients were higher in the observation group than in the control group(P<0.05). Conclusion application of schematic diagram for arteriovenous fistula puncture,effectively decreases incidence of exudation from puncture point and incidence of fistula complication, improves nursing quality and satisfaction of patients.
引文
[1] 王质刚.血液净化学[M].北京:北京科学技术出版社,2016:171-172.
[2] National kidney Foundation.K/DOQI clinical practice Guidelines for Vascular Access update 2000[J].Am J Kidney Dis,2001,37(Suppl 1):S137-S181.
[3] 张晓燕.两种动静脉穿刺法的临床效果比较[J].当代临床医刊,2015,28(6):1738-1739.
[4] 向晶,马志芳.血液透析专科护理操作指南[M].北京:人民卫生出版社,2014:167-168.
[5] 肖光辉,王玉柱.血液净化通路一体化管理手册[M].北京:北京航空航天大学出版社,2018:59-60,73-74.
[6] 易柏林,李家莲,全丽霞.血液透析病人动静脉内瘘狭窄行球囊扩张术后护理对策[J].当代护士(中旬刊),2017,(11):112-114.
[7] Krivistski NM.Theory and validation of access flow measurement by dilution technique during hemodialysis [J].Kidney Int,2015,48:244-250.
[8] Depner TA,Krivitsky NM.Clinical measurement of blood flow in hemodialysis access fistular and grafts by ultrasound dilution[J].ASAIO J,1995,41(3):M745-M749.
[9] 孙懿,刘慧兰.血液透析患者动静脉内瘘动脉瘤形成的原因及预防措施[J].中国血液净化,2005,4(1):29-31.
[2] National kidney Foundation.K/DOQI clinical practice Guidelines for Vascular Access update 2000[J].Am J Kidney Dis,2001,37(Suppl 1):S137-S181.
[3] 张晓燕.两种动静脉穿刺法的临床效果比较[J].当代临床医刊,2015,28(6):1738-1739.
[4] 向晶,马志芳.血液透析专科护理操作指南[M].北京:人民卫生出版社,2014:167-168.
[5] 肖光辉,王玉柱.血液净化通路一体化管理手册[M].北京:北京航空航天大学出版社,2018:59-60,73-74.
[6] 易柏林,李家莲,全丽霞.血液透析病人动静脉内瘘狭窄行球囊扩张术后护理对策[J].当代护士(中旬刊),2017,(11):112-114.
[7] Krivistski NM.Theory and validation of access flow measurement by dilution technique during hemodialysis [J].Kidney Int,2015,48:244-250.
[8] Depner TA,Krivitsky NM.Clinical measurement of blood flow in hemodialysis access fistular and grafts by ultrasound dilution[J].ASAIO J,1995,41(3):M745-M749.
[9] 孙懿,刘慧兰.血液透析患者动静脉内瘘动脉瘤形成的原因及预防措施[J].中国血液净化,2005,4(1):29-31.