维持性血液透析患者血管通路再循环率影响因素分析  

The influencing factors of vascular access recirculation in patients with maintainence hemadialysis

作　　者：陈云波[1] 贾环宇[1] 矫建梅[1] 张严松[1] 王滢[1] 刘露[1] 胡东滨[1] 

机构地区：[1]哈尔滨医科大学附属第二医院血液净化中心,哈尔滨市150086

出　　处：《护理管理杂志》2012年第5期333-334,348,共3页Journal of Nursing Administration

基　　金：2009年黑龙江省教育厅科研课题(11541191)

摘　　要：目的分析维持性血液透析患者血管通路再循环的影响因素,为护理干预提供依据。方法将90例维持性血液透析患者根据不同血管通路分成两组:内瘘穿刺组51例和中心静脉置管组39例,以血流量250 ml/min为基础值,根据不同的内瘘穿刺间距(4 cm、6 cm、8 cm、10 cm)、不同的动静脉压(以13.3 kPa为观察值)采用尿素法监测血中肌酐和尿素氮值进行再循环率测定。结果两组患者血管通路再循环率差异无统计学意义(P>0.05);再循环率与血管穿刺间距呈负相关(P<0.05),与动、静脉压两者均呈正相关(P<0.01)。结论血液通路再循环率与内瘘穿刺间距、血流量、动脉引出压力和静脉回流压力相关,针对其影响因素护理人员应提前给予护理干预。Objective To analyze the influencing factors of vascular access recirculation in patients with maintainence hemodialysis,thus to provide basis for nursing intervention. Methods Ninety hemodialysis patients were divided into two groups ,51 cases in internal fistula puncture group and 39 cases in central vein catheterization group. The basic blood flow was 250 ml/min. According to different internal fistula puncture intervals （4 cm,6 cm,8 em,10 cm） and different kinds of dynamic pulse pressure （ 13.3 kPa as observation value） ,the blood creatinine and urea nitrogen were measured by urea method for recirculation determination. Results The recirculation had no significant difference between the two groups （ P 〉 0.05 ）. Internal fistula puncture spacing was negatively correla- ted with the rate of recirculation （ P 〈 0.05 ）. Arterial and venous pressure were positively correlated with the rate of recireulation （ P 〈 0.01 ）. Conclusion The recirculation is related with internal fistula intervals, blood flow, arterial and venous pressure, so early nursing intervention should be taken for prevention.

关 键 词：血液透析 再循环 护理管理 

分 类 号：R47[医药卫生—护理学] C931.2[医药卫生—临床医学]