北京市自体动静脉内瘘功能不良监测情况的横断面调查  

The surveillance of Arteriovenous Fistula dysfunction in Beijing hemodialysis centers:a cross-sectional survey

作　　者：刘瑶[1] 王志稳[2] 向晶[3] 苏默[4] 苏春燕[5] 孙慧 娟陈育青 郑茜子[1] 曹立云[1] LIU Yao;WANG Zhiwen;XIANG Jing;SU Mo;SU Chunyan;SUN Huijuan;CHEN Yuqing;ZHENG Xizi;CAO Liyun(Renal Division,Department of Medicine,Peking University First Hospital/Institute of Nephrology,Peking University/Key Laboratory of Renal Disease,Ministry of Health of China/Key Laboratory of Chronic Kidney Disease Prevention and Treatment,Ministry of Education/Research Units of Diagnosis and Treatment of Immune-mediated Kidney Diseases,Chinese Academy of Medical Sciences,Beijing,100034,China)

机构地区：[1]北京大学第一医院肾内科,北京大学肾脏疾病研究所,卫生部肾脏疾病重点实验室,慢性肾脏病防治教育部重点实验室,中国医学科学院免疫介导肾病诊治创新单元,北京市100034 [2]北京大学护理学院 [3]解放军总医院第一医学中心肾脏科 [4]中日友好医院肾病科血液净化中心 [5]北京大学第三医院肾内科 [6]北京医院肾内科

出　　处：《中国护理管理》2021年第11期1651-1655,共5页Chinese Nursing Management

摘　　要：目的:调查北京市血液透析中心自体动静脉内瘘(AVF)功能不良监测的实施情况。方法:通过自行设计的问卷,对北京市各级医疗机构的123家血液透析中心的基本情况和AVF功能不良监测的实施情况进行调查,并分析结果。结果:北京市123家血液透析中心对AVF功能不良监测的实施情况中,除了患者宣教的实施率为92.68%外,其余有关流程和制度、人员和监测方法及内容的各项条目实施率均低于70.00%。此外,三级医院与非三级医院的血液透析中心在有无由多学科团队组成的血管通路小组(χ^(2)=10.593,P=0.001)、是否每次穿刺前进行物理检查(χ^(2)=5.752,P=0.016)及是否对患者宣教(χ^(2)=7.102,P=0.008)方面的差异有统计学意义。结论:北京市123家血液透析中心在AVF功能不良监测的流程和制度、人员、监测方法及内容层面仍有较大的改进空间,未来需要基于最佳证据建立起相关规范,并优化和均衡医疗资源,以提高对血管通路的整体管理水平。Objective:To investigate the implementation of Arteriovenous Fistula(AVF)dysfunction surveillance in Beijing hemodialysis centers.Methods:Through a self-designed questionnaire,the basic situation of 123 hemodialysis centers in medical institutions at all levels in Beijing and the implementation of surveillance of AVF dysfunction were investigated,and the results were analyzed.Results:In the implementation of AVF dysfunction surveillance by Beijing hemodialysis centers,in addition to the implementation rate of patient education of 92.68%,the implementation rate of other items related to procedures and systems,personnel and surveillance methods and contents were all below 70.00%.In addition,there were statistically significant differences between the hemodialysis centers of tertiary and non-tertiary hospitals in vascular access group(χ^(2)=10.593,P=0.001),physical examination(χ^(2)=5.752,P=0.016)and patient education(χ^(2)=7.102,P=0.008).Conclusion:There is still much room for improvement in the monitoring procedures and systems,personnel,surveillance methods and contents of AVF dysfunction in Beijing hemodialysis centers.In order to improve the management level of vascular access as a whole,relevant regulations should be established based on the best evidence and medical resources should be optimized and adjusted.

关 键 词：自体动静脉内瘘 功能不良 监测 

分 类 号：R47[医药卫生—护理学] R197[医药卫生—临床医学]