钝针扣眼穿刺法对血液透析患者内瘘的影响  

Study on the effect of button-hole puncture with blunt needle on the arteriovenous internal fistula of hemodialysis patients

作　　者：安克润[1] 罗小兰[1] 

机构地区：[1]四川省凉山州第一人民医院血液净化室,凉山615000

出　　处：《当代护士（中旬刊）》2016年第11期123-125,共3页Modern Nurse

摘　　要：目的观察扣眼穿刺法对血液透析患者内瘘的影响。方法选择血液净化室新成熟的内瘘患者90例,随机分成A组、B组和C 3组各30例,分别接受绳梯穿刺法、区域穿刺法和扣眼穿刺法,采用视觉模拟评分法(VAS)评价疼痛状况,比较3组内瘘并发症和穿刺疗效等指标。结果 B组VAS评分高于A组和C组(P<0.05);A组的VAS评分高于C组(P<0.05)。3组一次性穿刺成功率比较差异无统计学意义(P>0.05);B组的血流量降低、渗血、血肿和血管弹性变差的发生率都明显高于A组和C组(P<0.05);A组和C组之间各项指标比较差异无统计学意义(P>0.05)。B组的内瘘狭窄、内瘘阻塞、内瘘感染、血管瘤和总的并发症发生率均明显高于A组和C组(P<0.05);A组总并发症发生率明显高于C组(P<0.05)。结论动静脉内瘘扣眼法穿刺采用钝针可有效保护血管,减轻患者疼痛,降低内瘘并发症的发生率。Objective To investigate the effect of button -hole puncture with blunt needle on the arteriovenous internal fistula of hemodialy-sis patients.Methods Hemodialysis patients with new mature arteriovenous internal fistula in the number of 90 were randomly sampled and divided into three groups including group A,group B and group C,each with 30 patients.Patients in three groups received rope -ladder,re-gional and button -hole puncture respectively.Then we compared the scores of VAS,the complications and the clinical effect among the three groups.Results The scores of VAS in group B was higher than group A and group C（P ＆lt;0.05）,and group A was higher than group C （P＆lt;0.05）.The three groups showed no statistical significance in one -time success rate of puncture（P ＆gt;0.05）.The incidence rates of blood flow reduction,bleeding,hematoma and vascular elasticity variation of group B were higher than group A and group C（P ＆lt;0.05）,but with no statistical significance between group A and group C（P ＆gt;0.05）.The complications including internal fistula stenosis,fistal obstruction, infection of inernal fistula,hemangioma and the overall incidence rates of group B were higher than group A and group C（P ＆lt;0.05）,at the same time,the overall incidence rate of group A was higher than group C（P ＆lt;0.05）.Conclusion Button -hole puncture with blunt needle is effective in protecting the blood vessels,relieving patients’pain and reduding the complication rates.

关 键 词：血液透析 动静脉内瘘 钝针 扣眼穿刺法 

分 类 号：R473.5[医药卫生—护理学]