血液透析患者动静脉内瘘早期穿刺中不采用止血带的可行性与安全性  

Feasibility and safety of early puncture without tourniquet for arteriovenous internal fistula in patients with hemodialysis

作　　者：吴淑芳 梁艺娟 WU Shufang;LIANG Yijuan(Department of Hemodialysis Room,the Second Affiliated Hospital of Fujian Medical University,Quanzhou,Fujian,362000,China)

机构地区：[1]福建医科大学附属第二医院血透室,福建泉州362000

出　　处：《当代医学》2023年第34期91-94,共4页Contemporary Medicine

摘　　要：目的探讨血液透析患者动静脉内瘘早期穿刺中不使用止血带的可行性和安全性。方法选取2015年3月至2020年3月福建医科大学附属第二医院收治的100例血液透析行动静脉内瘘术患者作为研究对象,按照建内瘘中是否使用止血带分为研究组(n=51)与对照组(n=49)。两组均经动静脉内瘘早期穿刺行血液透析治疗,研究组新建内瘘中不使用止血带,对照组新建内瘘中使用止血带,比较两组穿刺出血率、穿刺前平均压迫时间、穿刺点渗血率、首次穿刺成功率、穿刺疼痛发生情况及穿刺相关并发症发生率。结果研究组穿刺1、5、10min后出血率均低于对照组,差异有统计学意义(P<0.05)。研究组穿刺前平均压迫时间长于对照组,穿刺点渗血率低于对照组,差异有统计学意义(P<0.05);两组首次穿刺成功率比较差异无统计学意义。研究组穿刺疼痛发生率低于对照组,差异有统计学意义(P<0.05)。研究组穿刺相关并发症发生率低于对照组,差异有统计学意义(P<0.05)。结论血液透析患者动静脉内瘘早期穿刺中不采用止血带虽可延长穿刺前平均压迫时间,但可降低穿刺后出血发生率、穿刺点渗血率及并发症发生率,减轻患者穿刺疼痛感,且不影响首次穿刺成功率。Objective To investigate the feasibility and safety of early puncture without tourniquet for arteriovenous internal fistula in patients with hemodialysis.Methods 100 patients with hemodialysis undergoing arteriovenous internal fistula surgery in the Second Affiliated Hospital of Fujian Medical University from March 2015 to March 2020 were selected as the research subjects,and they were divided into the study group(n=52)and the control group(n=48)according to whether tourniquet was used in fistula construction.Both groups received early puncture of arteriovenous internal fistula for hemodialysis,the tourniquet was not used in the new internal fistula in the study group,while the tourniquet was used in the new internal fistula in the control group,the puncture bleeding rate,average compression time before puncture,blood seepage rate of puncture point,first puncture success rate,the incidence of puncture pain and total incidence rate of puncture related complications were compared between the two groups.Results The bleeding rates after 1,5 and 10 min of puncture in the study group were lower than those in the control group,and the differenc-es were statistically significant(P<0.05).The average compression time before puncture in the study group was longer than that in the control group,and the blood seepage rate of puncture point was lower than that in the control group,the differences were statistically significant(P<0.05);there was no significant difference in the success rate of first puncture between the two groups.The incidence of puncture pain in the study group was lower than that in the control group,and the difference was statistically significant(P<0.05).The incidence of puncture related complications in the study group was lower than that in the control group,and the difference was statistically significant(P<0.05).Conclusion Although the early punc-ture without tourniquet for arteriovenous internal fistula in patients with hemodialysis can prolong the average compression time before puncture,but it can r

关 键 词：血液透析 动静脉内瘘穿刺 止血带 安全 

分 类 号：R692[医药卫生—泌尿科学]