不同穿刺方法对CKD-5期慢性肾病患者动静脉内瘘维护效果及并发症的影响  

Effects of Different Puncture Methods on Maintenance of Arteriovenous Fistulas and Complications in CKD-5 Chronic Kidney Disease Patients

作　　者：周圣娟 任丽仪 徐晓洁 叶雪雯 边宝娟 叶贵梅 温银瑞 ZHOU Sheng-juan;REN Li-yi;XU Xiao-jie;YE Xue-wen;BIAN Bao-juan;YE Gui-mei;WEN Yin-rui(Dalang Hospital of Dongguan City,Dongguan,Guangdong 523770)

机构地区：[1]东莞市大朗医院,广东东莞523770

出　　处：《智慧健康》2021年第22期147-149,共3页Smart Healthcare

基　　金：不同穿刺方法结合多普光红外线照射对动静脉内瘘维护的效果分析,东莞市社会科技发展(一般)项目(项目编号:202050715040211)。

摘　　要：目的探究不同穿刺方法对CKD-5期慢性肾病患者动静脉内瘘维护效果及并发症的影响.方法选取2019年1月至2020年1月于东莞市大朗医院进行血液透析的CKD-5期慢性肾病患者50例,按随机数字表法将患者分为向心组、离心组,两组各25例,其中向心组行绳梯向心穿刺,离心组行区域离心穿刺,两组均结合多普光红外线照射,持续随访1年,比较两组透析充分性、并发症及患者穿刺满意度差异.结果干预1年后,向心组尿素下降率(URR)、尿素清除指数(Kt/V)明显高于离心组(P<0.05);穿刺后,向心组内瘘血管狭窄、动脉瘤、血流量不足、渗血、血肿、感染、血管闭塞等并发症总发生率明显高于离心组(P<0.05);两组穿刺成功率比较差异无统计学意义(P>0.05),向心组患者穿刺满意度均明显高于离心组(P<0.05).结论绳梯向心穿刺可提高CKD-5期慢性肾病患者透析充分性,降低患者动静脉内瘘并发症发生率,有助于提高患者满意度.Objective To investigate the effects of different puncture methods on the maintenance of arteriovenous fistulas and complications in patients with CKD stage-5 chronic kidney disease.Methods 50 CKD-5 stage CKD-5 CKD patients undergoing hemodialysis at Da Lang Hospital of Dongguan City from January 2019 to January 2020 were selected,and the patients were divided into centrifugation group according to the random number table method,25 in each group,in which a rope ladder centrifugation was performed in the centrifugation group,and regional centrifugation was performed in the centrifugation group,in which both groups were combined with polypropyl infrared irradiation and continued to be followed up for 1 year to compare the adequacy of dialysis and complications between the two groupsAnd differences in patient satisfaction with puncture.Results After 1 year of intervention,the urea decline rate(URR)and urea clearance index(Kt/V)in centrifugation group were significantly higher than those in centrifugation group(P<0.05).After puncture,the total incidence of complications such as stenosis,aneurysm,blood flow deficiency,hemorrhage,hematoma,infection,and vascular occlusion in centrifugation group was significantly higher than that in centrifugation group(P<0.05).There was no significant difference between the two groups in the success rate of puncture(P>0.05),and patients in the centrifugation group were more satisfied with the puncture than those in the centrifugation group(P<0.05).Conclusion Central puncture of a rope ladder can improve the adequacy of dialysis and reduce the complication rate of arteriovenous fistula in patients with CKD-5 stage chronic kidney disease,which will help to improve patient satisfaction.

关 键 词：CKD-5期慢性肾病 动静脉内瘘 绳梯向心穿刺 区域离心穿刺 维护效果 并发症 

分 类 号：R473.5[医药卫生—护理学]