不用止血带对血液透析患者动静脉内瘘穿刺出血的影响研究  

Study on the effect of bleeding of arteriovenous fistula puncture for patients with hemodialysis without tourniquet

作　　者：邓东亲[1] 葛文娥[1] 魏晓霞[1] 李晓凤[1] 

机构地区：[1]苏州大学附属第四医院血液透析中心,江苏无锡214062

出　　处：《护士进修杂志》2008年第23期2117-2118,共2页Journal of Nurses Training

摘　　要：目的探讨血液透析患者不用止血带行动静脉内瘘穿刺的可行性。方法选择规律性血液透析1-10年的患者64例,观察每例患者连续四次动静脉内瘘穿刺后1 min、5 min、10 min穿刺点渗血清况。其中第一三次不用止血带,作为实验组;第二四次穿刺时用止血带,作为对照组,进行自身对照。结果穿刺后1 min、5 min渗血情况组间差异明显,实验组少于对照组（P〈0.01）。10 min渗血发生率组间差异无意义（P〉0.05）。一次性穿刺成功率两组差异无意义（P〉0.05）。结论不用止血带行动静脉内瘘穿刺,可以用于规律性血液透析一年以上的患者,其能够减少穿刺点渗血的发生率,不影响一次性穿刺成功率。Objective To study the feasibility of arteriovenous fistula puncture for patients with hemodialysis without tourniquet. Method 64 patients with regular hemodialysis for 1 to 10 years were selected. The bleeding oozing at puncture point was continuously observed four times 1 min, 5 min and 10 min after arteriovenous fistula puncture. As experimental group, the first and third arteriovenous fistula puncture do not have tourniquet, As control group, the second and the fourth arteriovenous fistula puncture have tourniquet. Result There was significant difference in bleeding oozing 1 min and 5 min after arteriovenous fistula puncture. The bleeding oozing in experimental group was significant less than that of control group （P〈0.01）. The rate of bleeding oozing 10 min after puncture was no significant difference between group （P〉0. 05）. Conclusion The rate of bleeding oozing at puncture point could be reduced by arteriovenous fistula puncture without tourniquet for patients with regular hemodialysis for over one year. The one-time success rate of puncture will not be affected.

关 键 词：血液透析 动静脉内瘘 止血带 出血 

分 类 号：R472.9[医药卫生—护理学] R459.5[医药卫生—临床医学]