超声引导下自体动静脉内瘘穿刺的最佳证据总结  

Evidence summary for ultrasound-guided autogenous arteriovenous fistula puncture

作　　者：唐思凯 陈林[1,2] 张颖君[1,2] 何莉 陈辉[1,2] 刘莉 石梅[1,2] 郑浩天 TANG Si-kai;CHEN Lin;ZHANG Ying-jun;HE Li;CHEN Hui;LIU Li;SHI Mei;ZHENG Hao-tian(Hemodialysis Division,Department of Nephrology,West China Hospital,Sichuan University,Chengdu 610041,China;West China School of Nursing,Sichuan University,Chengdu 610041,China)

机构地区：[1]四川大学华西医院肾脏内科血液透析室,成都610041 [2]四川大学华西护理学院,成都610041

出　　处：《中国血液净化》2024年第11期859-863,共5页Chinese Journal of Blood Purification

摘　　要：目的检索、评价和总结超声引导下自体动静脉内瘘(arteriovenous fistula,AVF)穿刺的最佳证据。方法系统检索数据库中关于维持性血液透析患者超声引导下AVF穿刺的相关证据,文献类型包括临床指南、系统评价、专家共识、随机对照试验等。检索时限为2013年1月—2023年11月。循证小组进行文献筛选、质量评价并提取、汇总证据。结果共筛选出21篇文献,包括5篇指南、3篇专家共识、1篇系统评价、10篇随机对照试验及2篇横断面研究。从实时超声引导下AVF穿刺、基于超声评估、穿刺前准备、超声引导AVF穿刺、穿刺后观察、超声培训6个方面汇总证据25条。结论总结的超声引导下AVF穿刺最佳证据可作为临床护理人员实施超声引导下AVF穿刺的指引与规范,以提升AVF穿刺成功率,减少穿刺相关并发症,保障患者安全。Objective To search,evaluate and summarize the best evidence for ultrasound-guided autogenous arteriovenous fistula(AVF)puncture.Methods A systematic search of databases for evidence on ultrasound-guided autogenous AVF puncture in maintenance hemodialysis patients was performed,with literature types including clinical guidelines,systematic evaluations,expert consensus,randomized controlled trials and others.The time frame for the search was January 2013 to November 2023.An evidence-based team performed literature screening and quality assessment,and extracted and summarized the evidence.Results A total of 21 publications were screened,including 5 guidelines,3 expert consensus,one systematic evaluation,10 randomized controlled trials,and 2 cross-sectional studies.Twenty-five pieces of the evidence were summarized in six areas:concepts related to ultrasound-guided fistula puncture,ultrasound-based vascular assessment,preparation and methods,post-puncture observation,and ultrasound-related training.Conclusion The summarized best evidence for ultrasound-guided fistula puncture can be used as a guideline and norm for clinical caregivers to increase puncture success rate,reduce puncture-related complications,and ensure patient safety.

关 键 词：超声引导 内瘘穿刺 最佳证据总结 

分 类 号：R318.16[医药卫生—生物医学工程]