钝针扣眼穿刺对血液透析患者动静脉内瘘并发症的影响  

Effect of Buttonhole Cannulation with Blunt Needle onComplications of Arteriovenous Fistula in Hemodialysis Patients

作　　者：陶玲玲[1] 曾财花 殷鹭 程静[1] 李敏[1] TAO Ling-ling;ZENG Cai-hua;YIN Lu;CHENG Jing;LI Min(Blood Purification Room of the First Affiliated Hospital of Nanchang University,Nanchang 330006,China)

机构地区：[1]南昌大学第一附属医院血透室,南昌330006

出　　处：《实用临床医学（江西）》2022年第5期70-72,100,共4页Practical Clinical Medicine

基　　金：江西省卫健委计划项目(202130306)。

摘　　要：目的 探讨钝针扣眼穿刺对血液透析患者动静脉内瘘并发症的影响。方法 将56例采用动静脉内瘘行维持性血液透析治疗患者按随机数字表法分为观察组与对照组,每组28例。观察组采用钝针扣眼穿刺法,对照组采用锐针绳梯穿刺法。比较2组一次性穿刺成功率、穿刺疼痛程度、穿刺点渗血发生率、动静脉内瘘并发症发生率及穿刺处患者满意度。结果 与对照组比较,观察组一次性穿刺成功率及穿刺处患者满意度显著升高,穿刺点渗血发生率、穿刺疼痛程度及动静脉内瘘并发症(内瘘闭塞、内瘘狭窄、假性动脉瘤)发生率显著降低,差异均有统计学意义(P<0.05)。结论 钝针扣眼穿刺法可以有效降低动静脉内瘘并发症的发生率,提高穿刺成功率,减少穿刺点渗血,减轻穿刺疼痛。Objective To investigate the effect of buttonhole cannulation with blunt needle on the complications of arteriovenous fistula in hemodialysis patients.Methods Fifty-six patients undergoing maintenance hemodialysis via arteriovenous fistula were randomly assigned to receive either buttonhole cannulation with blunt needle(observation group,28 cases)or rope ladder cannulation with sharp needle(control group,28 cases).The first-attempt success rate of puncture,degree of puncture pain,incidence of puncture bleeding,incidence of arteriovenous fistula complications,and patient satisfaction were compared between the two groups.Results The first-attempt success rate of puncture and patient satisfaction with puncture in the observation group were higher than those in the control group(P<0.05).The incidence of puncture bleeding,degree of puncture pain and incidence of arteriovenous fistula complications(occlusion,stenosis and pseudoaneurysm)in the observation group were lower than those in the control group(P<0.05).Conclusion Buttonhole cannulation with blunt needle can effectively decrease the incidence of arteriovenous fistula complications,improve the success rate of puncture,reduce puncture site bleeding,and relieve puncture pain in hemodialysis patients.

关 键 词：钝针扣眼穿刺 锐针绳梯穿刺法 血液透析 动静脉内瘘 并发症 

分 类 号：R473.5[医药卫生—护理学]