两种穿刺法对血液透析患者动静脉内瘘的应用研究  

Application of Two Punctures in treating arteriovenous fistula in Hemodial-ysis Patients

作　　者：王红梅 

机构地区：[1]齐齐哈尔第二机床集团有限公司职工医院血液透析科,黑龙江齐齐哈尔161000

出　　处：《中外医疗》2015年第28期69-71,共3页China & Foreign Medical Treatment

摘　　要：目的研究探讨两种穿刺法对血液透析患者动静脉内瘘的应用。方法整群选取自2012年1月—2015年2月间于该院收治的行血液透析的肾功能衰竭患者66例,随机分为两组,绳梯组采用绳梯穿刺法进行穿刺,扣眼组采用扣眼穿刺法进行穿刺,对比观察两组的穿刺效果以及患者术后并发症。结果扣眼组的穿刺疼痛相比绳梯组的次数较少,且差异有统计学意义(χ2=71.38,P<0.05);扣眼组的穿刺成功率也要高于绳梯组,且差异有统计学意义(χ2=24.618,P<0.05)。扣眼组中形成血栓的患者例数为4例,而绳梯组形成血栓的患者例数为8例,两组的差异有统计学意义(χ2=8.427,P<0.05);扣眼组有内瘘狭窄或闭塞的患者例数为5例,而绳梯组有内瘘狭窄或闭塞的患者例数为12例,两组的差异有统计学意义(χ2=12.715,P<0.05)。结论扣眼穿刺法相对于绳梯穿刺法具有一定优势,扣眼穿刺法可有效避免穿刺时的疼痛,可避免一些并发症的发生,如形成血栓、血管瘤以及内瘘狭窄或闭塞等,而且该方法可提高穿刺的成功率。Objective To discuss the application of two punctures in treating arteriovenous fistula in hemodialysis patients. Methods 66 patients with renal failure who were admitted to and underwent hemodialysis in this hospital between January 2012 and February 2015 were enrolled and randomized to undergo rope-ladder puncture(the rope-ladder group) and buttonhole puncture(the buttonhole group). The outcome of punctures and postoperative complications were between the two groups. Results The pain was less in the buttonhole group than in the rope-ladder group with statistically significant, χ2=71.38, P<0.05. The successful rate was higher in the rope-ladder group with statistically significant, χ2=24.618, P<0.05. The thrombus was found in 4 patients in the buttonhole group and in 8 patients in the rope-ladder group, and the difference was statistically significant, χ2=8.427, P<0.05. Fistula stenosis or occlusion was found in 5 patients in the the buttonhole group and in 12 patients in the rope-ladder group, and the difference was statistically significant, χ2=12.715, P<0.05. Conclusion The buttonhole group is superior to the rope-ladder group because it can reduce the pain and avoid complications including thrombus, hemangioma, and fistula stenosis or occlusion, as well as improve the successful rate.

关 键 词：血液透析 动静脉内瘘 扣眼穿刺法 绳梯穿刺法 急慢性肾衰竭 

分 类 号：R472[医药卫生—护理学]