“桥式”固定法与“蝶式”固定法对减少动静脉内瘘血管损伤的效果比较  

Comparison of the effects of“bridge type”fixation and“butterfly type”fixation on reducing vascular injury of arteriovenous fistula

作　　者：黄路路 崔益鸿[1] 徐慧[1] HUANG Lulu;CUI Yihong;XU Hui(Hemodialysis Room,Hai’an People’s Hospital Affiliated to Nantong University,Hai’an Jiangsu 226600,China)

机构地区：[1]南通大学附属海安人民医院血透室,江苏海安226600

出　　处：《临床与病理杂志》2023年第5期944-950,共7页Journal of Clinical and Pathological Research

基　　金：南通市科技计划项目(MSZ2022156)。

摘　　要：目的:对比分析“桥式”固定法与“蝶式”固定法应用于动静脉内瘘血管损伤中的效果。方法:采用回顾性分析法,选择2020年3月至2022年3月南通大学附属海安人民医院收治的行维持性血液透析治疗的患者98例,将使用“蝶式”固定法固定穿刺针的49例患者作为对照组,将使用“桥式”固定法固定穿刺针的49例患者作为试验组。比较2组固定第3个月、6个月、9个月、12个月动静脉内瘘血管情况、透析情况、舒适度及动静脉内瘘并发症发生率。结果:试验组固定第6个月、9个月、12个月的穿刺处静脉管径、肱动脉血流量均高于对照组(均P<0.05);试验组透析机泵速<200 mL/min、静脉压>180 mmHg(1 mmHg=0.133 kPa)发生率均低于对照组(均P<0.05);试验组舒适度高于对照组,动静脉内瘘并发症总发生率低于对照组(均P<0.05)。结论:“桥式”固定法应用于维持性血液透析患者可减少动静脉内瘘血管损伤,效果显著。Objective:To compare and analyze the effect of“bridge”fixation and“butterfly”fixation in the vascular injury of arteriovenous fistula.Methods:Using the retrospective analysis method,98 patients treated in Hai’an People’s Hospital Affiliated to Nantong University from March 2020 to March 2022 were selected for maintenance hemodialysis treatment,49 patients who fixed the puncture needle with“butterfly”fixation method as the control group,and 49 patients who fixed the puncture needle with“bridge”fixation method as the experimental group.The arteriovenous fistula vascular conditions,dialysis conditions,comfort and the incidence of arteriovenous fistula complications were compared between the 2 groups at the 3rd,6th,9th,and 12th months of fixation.Results:The venous diameter and brachial artery blood flow at the puncture site in the experimental group at the 6th,9th,and 12th months of fixation were higher than those in the control group(all P<0.05).The incidence of the dialyzer pump speed<200 mL/min and the venous pressure>180 mmHg(1 mmHg=0.133 kPa)in the experimental group was lower than that in the control group(both P<0.05);the comfort level in the experimental group was higher,and the total incidence of arteriovenous fistula complications was lower than that in the control group(both P<0.05).Conclusion:“Bridge”fixation is effective for patients with maintenance hemodialysis by reducing vascular injury of arteriovenous fistula.

关 键 词：“桥式”固定法 “蝶式”固定法 维持性血液透析 动静脉内瘘 血管损伤 舒适度 并发症 

分 类 号：R459.5[医药卫生—治疗学]