动静脉内瘘早期穿刺方法研究进展
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摘要
肾功能衰竭患者主要是采取肾脏替代疗法治疗,以维持性血液透析为主,而实施该方法治疗前提在建立一条有效的血管通路;经调查发现三分之二的维持性血液透析患者选择动静脉内瘘作为血管通路,为此动静脉内瘘穿刺是血液净化专科护理人员必须掌握的技能;动静脉内瘘与中心静脉留置导管相比具有更大的优势,即通畅时间长,且并发症少,因此自2006年开始世界卫生组织强烈建议首选动静脉内瘘方法作为维持血液透析患者的血管通路,其利用显微外科小血管吻合技术行前壁动静脉内瘘成形术,以端侧吻合为主,有利于降低失功率;本文为了探讨动静脉内瘘早期穿刺方法,将近年来国内外相关动静脉内瘘早期穿刺方法等文献资料进行展开性综述,从而为更多的临床工作人员提供有效、客观的参考依据。
Renal failure patients maily are treated with replacement therapy, and main treatment is maintenance hemodialysis. Condition of the treatment is to establish an effective vascular access. Survey showes, two-thirds of maintenance hemodialysis patients choose arteriovenous fistula as vascular access, so arteriovenous fistula puncture is a must for nursing staffs of blood purification speciality. Compared with central venous catheter, arteriovenous fistula has more advantages, including long patency time and fewer complications. Since 2006, WHO has strongly recommended that arteriovenous fistula be the first choice for maintaining vascular access of hemodialysis patients, which performs anterior wall arteriovenous fistula plasty with microsurgical small vessel anastomosis technology, with end-to-side anastomosis mainly to reduce power loss. The paper explores early puncture methods of arteriovenous fistula, reviews related literature of early puncture methods of arteriovenous fistula at home and abroad in recent years, to provide effective and objective reference for clinical staffs.
Renal failure patients maily are treated with replacement therapy, and main treatment is maintenance hemodialysis. Condition of the treatment is to establish an effective vascular access. Survey showes, two-thirds of maintenance hemodialysis patients choose arteriovenous fistula as vascular access, so arteriovenous fistula puncture is a must for nursing staffs of blood purification speciality. Compared with central venous catheter, arteriovenous fistula has more advantages, including long patency time and fewer complications. Since 2006, WHO has strongly recommended that arteriovenous fistula be the first choice for maintaining vascular access of hemodialysis patients, which performs anterior wall arteriovenous fistula plasty with microsurgical small vessel anastomosis technology, with end-to-side anastomosis mainly to reduce power loss. The paper explores early puncture methods of arteriovenous fistula, reviews related literature of early puncture methods of arteriovenous fistula at home and abroad in recent years, to provide effective and objective reference for clinical staffs.
引文
[1]刘玲玲,黄薇,苏春燕.血液透析患者自体动静脉内瘘穿刺疼痛的研究进展[J].中国护理管理,2015,15(9):1145-1148.
[2]张晓燕.两种动静脉内瘘穿刺法的临床效果比较[J].当代临床医刊,2015,28(2):1300-1301.
[3]刘晶晶.低位自体动静脉内瘘的使用相关技术研究进展[J].安徽医药,2016,20(3):586-588.
[4]李淑秀,周永玲.自体动静脉内瘘应用早期的护理[J].护士进修杂志,2015,30(1):88-89.
[5]黄珊珊.不同穿刺方法对动静脉内瘘并发症的效果观察[J].中国保健营养,2015,25(14):258-259.
[6]杨红飞.维持性血液透析患者动静脉内瘘穿刺技巧探讨[J].医药前沿,2015,5(35):61-62.
[7]王磊.扣眼穿刺,坚持还是放弃?——自体动静脉内瘘扣眼穿刺技术研究进展[J].中国血液净化,2016,15(8):427-429.
[8]乔静.不同动静脉内瘘穿刺方法用于血液透析患者效果对比观察[J].中国现代药物应用,2016,10(1):234-235.
[9]王燕,郑桂.扣眼穿刺在自体动静脉内瘘应用中的研究进展[J].护理与康复,2017,16(11):1166-1169.
[10]赵丽娟,林初媛,龚丽萍.扣眼穿刺在血液透析中自体动静脉内瘘应用的研究进展[J].黑龙江医药,2015,28(5):1171-1173.
[11]张雨钰,尤佩,杨蓓.减压穿刺法在自体动静脉内瘘早期穿刺中的应用[J].中西医结合护理(中英文),2017,3(6):109-111.
[12]李家莲,全丽霞,韦红,等.穿刺方向对不同内径动静脉内瘘影响的研究进展[J].中西医结合护理(中英文),2017,3(4):180-182.
[13]郑薇.不用止血带穿刺在血液透析患者动静脉内瘘早期穿刺中的应用研究[J].实用临床医药杂志,2016,20(8):137-138.
[14]康彩花,高翠莲,张艳,等.扣眼穿刺技术在维持性血液透析中的研究进展[J].实用临床医药杂志,2017,21(10):215-218.
[15]刘北力.穿刺方法对血透动静脉内瘘并发症的效果观察[J].医学信息,2016,29(32):231-231.
[16]尹海辉,周采平,任伟.扣眼法应用于动静脉内瘘穿刺的研究进展[J].护理学杂志,2014,29(13):92-95.
[17]杨海棠.自体动静脉内瘘首次穿刺的技巧及护理方法分析[J].临床医药文献电子杂志,2016,3(59):11831-11832.
[18]严贺,金凤兰,童辉,等.两种穿刺方法对动静脉内瘘并发症和患者疼痛的影响[J].护理学杂志,2014,29(1):24-26.
[2]张晓燕.两种动静脉内瘘穿刺法的临床效果比较[J].当代临床医刊,2015,28(2):1300-1301.
[3]刘晶晶.低位自体动静脉内瘘的使用相关技术研究进展[J].安徽医药,2016,20(3):586-588.
[4]李淑秀,周永玲.自体动静脉内瘘应用早期的护理[J].护士进修杂志,2015,30(1):88-89.
[5]黄珊珊.不同穿刺方法对动静脉内瘘并发症的效果观察[J].中国保健营养,2015,25(14):258-259.
[6]杨红飞.维持性血液透析患者动静脉内瘘穿刺技巧探讨[J].医药前沿,2015,5(35):61-62.
[7]王磊.扣眼穿刺,坚持还是放弃?——自体动静脉内瘘扣眼穿刺技术研究进展[J].中国血液净化,2016,15(8):427-429.
[8]乔静.不同动静脉内瘘穿刺方法用于血液透析患者效果对比观察[J].中国现代药物应用,2016,10(1):234-235.
[9]王燕,郑桂.扣眼穿刺在自体动静脉内瘘应用中的研究进展[J].护理与康复,2017,16(11):1166-1169.
[10]赵丽娟,林初媛,龚丽萍.扣眼穿刺在血液透析中自体动静脉内瘘应用的研究进展[J].黑龙江医药,2015,28(5):1171-1173.
[11]张雨钰,尤佩,杨蓓.减压穿刺法在自体动静脉内瘘早期穿刺中的应用[J].中西医结合护理(中英文),2017,3(6):109-111.
[12]李家莲,全丽霞,韦红,等.穿刺方向对不同内径动静脉内瘘影响的研究进展[J].中西医结合护理(中英文),2017,3(4):180-182.
[13]郑薇.不用止血带穿刺在血液透析患者动静脉内瘘早期穿刺中的应用研究[J].实用临床医药杂志,2016,20(8):137-138.
[14]康彩花,高翠莲,张艳,等.扣眼穿刺技术在维持性血液透析中的研究进展[J].实用临床医药杂志,2017,21(10):215-218.
[15]刘北力.穿刺方法对血透动静脉内瘘并发症的效果观察[J].医学信息,2016,29(32):231-231.
[16]尹海辉,周采平,任伟.扣眼法应用于动静脉内瘘穿刺的研究进展[J].护理学杂志,2014,29(13):92-95.
[17]杨海棠.自体动静脉内瘘首次穿刺的技巧及护理方法分析[J].临床医药文献电子杂志,2016,3(59):11831-11832.
[18]严贺,金凤兰,童辉,等.两种穿刺方法对动静脉内瘘并发症和患者疼痛的影响[J].护理学杂志,2014,29(1):24-26.