维持性血液透析患者自体动静脉内瘘并发症自我管理现状及影响因素分析  

Current status and influencing factors of self-management of autologous arteriovenous fistula complications in maintenance hemodialysis patients

作　　者：薛贵方 杨玉洁[1] 袁怀红[1] 张颖君[1] 马登艳[1] XUE Guifang;YANG Yujie;YUAN Huaihong;ZHANG Yingjun;MA Dengyan(Department of Nephrology,Hemodialysis Center,West China Hospital Sichuan UniversityWest China School of Nursing,Sichuan Province,Chengdu610041,China)

机构地区：[1]四川大学华西医院肾脏内科血液透析中心华西护理学院,四川成都610041

出　　处：《中国医药导报》2020年第33期74-77,89,共5页China Medical Herald

基　　金：四川省科学技术厅重点研发项目(2019YFS0289)。

摘　　要：目的了解维持性血液透析(MHD)患者自体动静脉内瘘(AVF)并发症自我管理的现状,探讨其影响因素。方法采用自行设计的一般资料调查表、AVF并发症自我管理量表,于2020年1—4月在四川大学华西医院血透中心透析治疗的182例MHD患者进行横断面调查。结果本研究共发放问卷182份,回收问卷182份,回收率为100%,有效问卷181份,有效率为99.5%。不同透析龄、医疗支付方式、自检内瘘频率和监测血压频率与MHD患者AVF并发症自我管理得分比较,差异有统计学意义(P<0.05)。MHD患者AVF并发症自我管理总分为(63.13±6.64)分;最低得分维度是并发症的预防得分为(11.14±1.90)分。多元线性回归分析显示,自检内瘘频率和监测血压频率是MHD患者AVF并发症自我管理的影响因素(P<0.01)。结论MHD患者AVF并发症自我管理总体处于中下水平,临床中应关注患者是否每天自检内瘘异常和每天是否监测血压变化,采取针对性的干预措施提高MHD患者AVF并发症自我管理的水平并保持血管通路功能的完好。Objective To understand the current status of self-management of autologous arteriovenous fistula(AVF)complications in maintenance hemodialysis(MHD)patients,and to explore its influencing factors.Methods A self-designed general information questionnaire and AVF complications self-management scale were used to conduct a cross-sectional survey of 182 MHD patients undergoing dialysis treatment in Hemodialysis Center,West China Hospital Sichuan University from January to April 2020.Results In this study,a total of 182 questionnaires were distributed and 182 were recovered,with a recovery rate of 100%,while a total of 181 valid questionnaires with an effective rate of 99.5%.There were statistically significant differences between the AVF complication self-management scores of patients with MHD with different ages,medical payment methods,self-checking of internal fistulas frequency and blood pressure monitoring frequency(P<0.05).The total score for self-management of AVF complications in MHD patients was(63.13±6.64)points;the lowest score dimension was the prevention score of complications(11.14±1.90)points.Multiple linear regression analysis showed that self-checking of internal fistula frequency and blood pressure monitoring frequency were influencing factors for self-management of AVF complications in MHD patients(P<0.01).Conclusion The self-management of AVF complications in MHD patients is generally at an intermediate to low level.In clinical practice,attention should be paid to whether patients self-check for internal fistula abnormalities and whether to monitor blood pressure changes every day.Targeted interventions should be taken to improve the level and maintenance of self-management of AVF complications in MHD patients,and the vascular access function should be keep intact.

关 键 词：维持性血液透析 动静脉内瘘 并发症 自我管理 影响因素 

分 类 号：R692.5[医药卫生—泌尿科学]