血液透析用动静脉内瘘穿刺点出血并发症的处理与预防经验分析  

Experience analysis of treatment and prevention of bleeding complications at puncture point of arteriovenous fistula for hemodialysis

作　　者：刘萍[1] 贺剑茵 秦琤 黄泓 许姗姗 忻之诚 LIU Ping;HE Jianyin;QIN Cheng;HUANG Hong;XU Shanshan;XIN Zhicheng(Hemodialysis Room,Huangpu Branch,Shanghai Ninth People's Hospital,Shanghai Jiaotong University School of Medicine,Shanghai 200011,China)

机构地区：[1]上海交通大学医学院附属第九人民医院黄浦分院血液透析室,上海200011

出　　处：《临床医学研究与实践》2024年第12期131-134,共4页Clinical Research and Practice

基　　金：上海市黄浦区卫生健康委员会科研项目(No.HKM201914)。

摘　　要：通过回顾性探讨和总结过去3年在本组血液透析(HD)患者中观察到的动静脉内瘘(AVF)穿刺点常见出血并发症,如轻度型(穿刺点渗血、皮下小血肿或血清肿)、中度型(皮下活动性急性出血伴大血肿)、重度型(穿刺点喷血或涌血)等处理和预防经验,发现原则上需及时处理、有效止血,并要注重日常预防。本文对2019版《中国血液透析用血管通路专家共识(第2版)》AVF出血并发症进行查阅,发现其中收录的出血并发症只有1种——血清肿,收录的种类存在不足,建议有关专家和护理同行对其进行完善,以便下一版“共识”更好地指导HD护理临床操作。By retrospectively discussing and summarizing the experience in the treatment and prevention of common bleeding complications at the puncture point of arteriovenous fistula(AVF),such as mild type(puncture point oozing blood,subcutaneous small hematoma or seroma),moderate type(subcutaneous active acute hemorrhage with large hematoma),severe type(puncture point spray blood or gushing blood)observed in this group of hemodialysis(HD)patients in the past 3 years,it is found that timely handling and effective hemostasis are necessary in principle,and attention should be paid to daily prevention.This paper reviewed the AVF bleeding complications in the 2019 edition of the"Expert Consensus on Vascular Access for Hemodialysis in China(2nd edition)",and found that there was only one bleeding complication included in seroma,the types included were insufficient.It is suggested that relevant experts and nursing peers should improve it so that the next edition of the"consensus"can better guide the clinical operation of HD nursing.

关 键 词：血液透析 动静脉内瘘 出血 并发症 

分 类 号：R473.5[医药卫生—护理学]