以血透护士为核心的多学科团队协作在维持性血液透析患者自体动静脉内瘘管理中的应用  

Application of Multidisciplinary Teamwork Centered on Hemodialysis Nurses in the Management of Autogenous Arteriovenous Fistula in Maintenance Hemodialysis Patients

作　　者：吴桃峰 陈静芳[1] 方晓兰 顾勤 WU Taofeng;CHEN Jingfang;FANG Xiaolan;GU Qin(Suzhou Municipal Hospital,Suzhou,Jiangsu 215000)

机构地区：[1]苏州市立医院,江苏苏州215000

出　　处：《上海护理》2022年第9期12-16,共5页Shanghai Nursing

摘　　要：目的探讨以血透护士为核心的多学科团队协作在维持性血液透析患者自体动静脉内瘘管理中的应用效果。方法将苏州市立医院2019年7月至2020年6月中每周一、三、五行血液透析的64例患者设为对照组,将2020年7月至2021年6月中每周二、四、六行血液透析的66例患者设为观察组。对照组采用自体动静脉内瘘常规使用及管理方法,观察组在对照组的基础上引入以血透护士为核心的多学科团队协作,血透护士在接受超声操作培训后实施优化后的自体动静脉内瘘使用及维护方案。比较两组维持性血液透析患者的内瘘一次穿刺成功率、自体动静脉内瘘并发症发生例数、因自体动静脉内瘘并发症住院次数及患者满意度、透析完成率、透析充分性等。结果观察组内瘘一次穿刺成功率、自体动静脉内瘘使用并发症例数、因内瘘并发症问题年住院次数、透析充分性均优于对照组(P<0.05),两组患者透析完成率、满意度比较差异无统计学意义(P>0.05)。结论以经过超声操作培训的血透护士为核心的多学科团队协作,在维持性血液透析患者自体动静脉内瘘使用中发挥了积极作用,降低了内瘘使用并发症,减少了患者因血管通路问题的住院次数。Objective To explore the effects of multidisciplinary teamwork centered on hemodialysis nurses on the management of autogenous arteriovenous fistula(aAVF)in maintenance hemodialysis patients.Methods A total of 64 patients with aAVF who underwent dialysis on Monday,Wednesday and Friday every week from July 2019 to June 2020 in Suzhou Municipal Hospital were selected and enrolled in the control group;a total of 66 patients with aAVF who underwent dialysis on Tuesday,Thursday and Saturday every week from July 2020 to June 2021 were selected and enrolled in the observation group.The control group was given routine aAVF use and management;on this basis,a multidisciplinary teamwork model centered on hemodialysis nurses was introduced to the observation group,in which hemodialysis nurses implemented an optimized aAVF use and maintenance program after receiving ultrasound operation training.The first-attempt success rate of aAVF puncture,the number of subjects with aAVF complications,the number of hospitalizations due to aAVF complications,patient satisfaction,dialysis completion rate and dialysis adequacy were compared between the two groups.Results The first-attempt success rate of aAVF puncture,the number of subjects with aAVF complications,the annual number of hospitalizations due to aAVF complications and dialysis adequacy in the observation group were superior to those in the control group(P<0.05).There was no significant difference in the dialysis completion rate and satisfaction between the two groups(P>0.05).Conclusion Multidisciplinary teamwork centered on hemodialysis nurses who were trained in ultrasound operation reduces aAVF complications and the number of hospitalizations due to vascular access problems,playing an active role in the use of aAVF in patients on maintenance hemodialysis.

关 键 词：维持性血液透析 自体动静脉内瘘 多学科团队协作 超声 护士 透析充分性 穿刺成功率 

分 类 号：R473.5[医药卫生—护理学]