自体动静脉内瘘导航护理方案对围透期患者头静脉/吻合口血流量、血液流变学指标的影响  

Effect of Autologous Arteriovenous Fistula Navigation Care Program on Cephalic Vein/Anastomotic Blood Flow and Hemorheological Indexes in Peri-Dialysis Patients

作　　者：吴彩 王延海[1] 余伟[1] WU Cai;WANG Yan-hai;YU Wei(Department of Blood Purification,First Affiliated Hospital of Nanyang Medical College,Nanyang,Henan,473000,China)

机构地区：[1]南阳医学高等专科学校第一附属医院血液净化科,河南南阳473000

出　　处：《中国血液流变学杂志》2024年第4期661-665,共5页Chinese Journal of Hemorheology

摘　　要：目的探究自体动静脉内瘘导航护理方案对围透期患者头静脉/吻合口血流量、血液流变学指标的影响。方法回顾性分析2022年1月—2023年12月68例围透期患者的临床资料。依据护理方式分为对照组、研究组,每组各34例。对照组患者应用常规护理,研究组患者应用自体动静脉内瘘导航护理。对比两组患者自我血管保护行为评分、内瘘自我管理能力、头静脉/吻合口内径、头静脉/吻合口血流量、血液流变学指标、透析充分性(Kt/V值)、内瘘成熟时间、护理满意度。结果研究组患者护理后自我血管保护行为评分、内瘘自我管理能力评分均高于对照组(P<0.05);研究组患者护理后头静脉/吻合口内径、头静脉/吻合口血流量均高于对照组(P<0.05);研究组患者护理后血小板聚集率、血浆黏度、红细胞压积、全血高切黏度均低于对照组(P<0.05);研究组患者首次透析Kt/V值高于对照组,内瘘成熟时间低于对照组(P<0.05);研究组患者护理满意度明显高于对照组(P<0.05)。结论自体动静脉内瘘导航护理方案可有效改善围透期患者自我管理能力,提高头静脉/吻合口内径、头静脉/吻合口血流量、透析充分性,下调血液流变学指标,缩短内瘘成熟时间,得到患者的满意评价,护理效果显著,值得临床推广。Objective To explore the effect of navigation nursing scheme of autologous arteriovenous fistula on cephalic vein/anastomotic blood flow and hemorheological indexes of patients in peri-dialysis period.Methods Clinical data of 68 patients in peri-dialysis period from January 2022 to December 2023 were analyzed retrospectively.They were divided into control group and study group according to the nursing method,with 34 cases in each group.Patients in control group were given regular nursing care,while patients in study group were given autologous arteriovenous fistula navigation care.Self-vascular protective behavior score,internal fistula self-management ability,cephalic vein/anastomotic internal diameter,cephalic vein/anastomotic blood flow,hemorheological indexes,dialysis adequacy(Kt/V value),maturity time of internal fistula and nursing satisfaction were compared between the two groups.Results Self-vascular protective behavior score and internal fistula self-management score of study group after nursing were higher than those of control group(P<0.05).Cephalic vein/anastomotic internal diameter and cephalic vein/anastomotic blood flow of study group after nursing were higher than those of control group(P<0.05).Platelet aggregation rate,plasma viscosity,hematocrit and whole blood high shear viscosity of study group after nursing were lower than those of control group(P<0.05).First Kt/V value of study group was higher than that of control group,and mature time of internal fistula was lower than that of control group(P<0.05).Nursing satisfaction of patients in study group was significantly higher than that in control group(P<0.05).Conclusion Autologous arteriovenous fistula navigation nursing plan can effectively improve peri-dialysis patients self-management ability,improve cephalic vein/anastomosis internal diameter,cephalic vein/anastomosis blood flow,dialysis adequacy,reduce hemorheological indexes,shorten mature time of internal fistula,and obtain satisfactory evaluation of patients.Nursing effect is remarkable

关 键 词：血液透析 自体动静脉内瘘 围透析期 导航护理 内瘘自我管理 血液流变学指标 

分 类 号：R473.5[医药卫生—护理学]