针尖斜面不同方向进针对内瘘血管的影响  

Influence of Different Insertion Directions of Needle Tip Inclined Plane on Internal Fistula Vessels

作　　者：吴伟娟[1] Wu Wei-juan(Department of Blood Purification,Dongguan Tungwah Hospital,Dongguan 523000,Guangdong Province,China)

机构地区：[1]东莞东华医院血液净化科,广东东莞523000

出　　处：《中国社区医师》2022年第8期130-132,共3页Chinese Community Doctors

摘　　要：目的:探讨动静脉内瘘穿刺采用针尖斜面不同方向进针对内瘘的影响。方法:选取2020年6月-2021年10月东莞东华医院收治的68例血液透析患者作为研究对象,根据不同穿刺角度分为对照组和研究组。对照组采用常规针尖斜面朝向上方进行穿刺,研究组采用穿刺时首先将针头倾斜一定角度进入血管后,斜面向下缓慢进针。对比两组患者内瘘穿刺时疼痛程度、心理状态评分以及内瘘并发症发生情况。结果:研究组患者内瘘穿刺时疼痛程度低于对照组(P<0.05);内瘘开始穿刺前两组患者心理状态评分无明显差异(P>0.05),穿刺6个月后、12个月后研究组患者焦虑评分和抑郁评分均低于对照组(P<0.05);此外研究组患者内瘘血管瘤、内瘘狭窄以及内瘘闭塞并发症发生率均低于对照组(P<0.05)。结论:对于血液透析患者采用针尖斜面倾斜向下方法能够保护动静脉内瘘血管,降低疼痛程度,改善患者心理状态,减少内瘘并发症的发生,提高透析临床治疗效果。Objective: To investigate the influence of different insertion directions of needle tip inclined plane in puncture of internal arteriovenous fistula on internal fistula. Methods: A total of 68 hemodialysis patients admitted to Dongguan Tungwah Hospital from June 2020 to October 2021 were selected as the subjects. They were divided into control group and study group according to different puncture angles. Control group was punctured with conventional needle tip inclined plane upward, and study group was punctured with the needle tip first inclined into the blood vessel at a certain angle, and then slowly inserted downward.The pain degree, mental state score and the occurrence of complications of the internal fistula were compared between the two groups of patients during internal fistula puncture. Results: The pain degree during the internal fistula puncture in study group was lower than that in control group(P<0.05);there was no significant difference in the mental state scores between the two groups before the start of internal fistula puncture(P>0.05);at 6 and 12 months after puncture, the anxiety score and depression score of the patients in study group were lower than those in control group(P<0.05);in addition, the incidences of complications such as internal fistula hemangioma, internal fistula stenosis and internal fistula occlusion in study group were lower than those in control group(P<0.05). Conclusion: For hemodialysis patients, the method of needle tip inclined plane in oblique downward direction can protect the internal arteriovenous fistula, reduce pain degree, improve the patient’s mental state, reduce the occurrence of internal fistula complications, and improve the clinical treatment effect of dialysis.

关 键 词：针尖斜面 动静脉内瘘 心理状态 内瘘并发症 

分 类 号：R473.5[医药卫生—护理学]