自体动静脉内瘘扣眼穿刺并发症的原因分析及护理
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摘要
目的:探讨自体动静脉内瘘使用钝针扣眼穿刺后发生并发症的原因及护理对策。方法:选择2015年5月～2018年5月在本院血液净化中心进行维持性血液透析患者258例,采用自体动静脉内瘘扣眼穿刺,分析发生并发症的原因及护理对策。结果:258例患者扣眼穿刺并发感染14例(5.43%)、穿刺点渗血12例(4.65%)、隧道狭窄10例(3.87%)穿刺点湿疹4例(1.55%)、血栓形成15例(5.81%)。结论:自体动静脉内瘘扣眼穿刺并发感染主要原因是患者免疫功能低下,卫生习惯不良和反复穿刺所致。虽然扣眼穿刺法提高了穿刺成功率,但也会发生一些并发症,经过原因分析及有效的护理措施,可以降低自体动静脉内瘘扣眼穿刺并发症的发生,延长内瘘使用寿命。
Objective: To investigate the causes and preventive measures of complications after autologous arteriovenous fistula with blunt needle buttonhole puncture. Methods: A total of 258 patients with maintenance hemodialysis were enrolled in the blood purification center of our hospital from May 2015 to May 2018. The causes of complications and nursing strategies after autologous arteriovenous fistula were used. Results: There were 14 cases(5.43%) with infection, 12 cases(4.65%) with bleeding, 10 cases(3.87%) with tunnel stenosis, 4 cases(1.55%) with eczema and 15 cases(5.81%) with thrombosis. Conclusion: The main cause of autologous arteriovenous fistula and puncturing is the low immune function, poor hygiene and repeated puncture. Although the buttonhole puncture method improves the success rate of puncture, some complications may occur. After the cause analysis and effective nursing measures, the complications of autologous arteriovenous fistula puncture can be reduced, and the service life of the internal fistula can be prolonged.
Objective: To investigate the causes and preventive measures of complications after autologous arteriovenous fistula with blunt needle buttonhole puncture. Methods: A total of 258 patients with maintenance hemodialysis were enrolled in the blood purification center of our hospital from May 2015 to May 2018. The causes of complications and nursing strategies after autologous arteriovenous fistula were used. Results: There were 14 cases(5.43%) with infection, 12 cases(4.65%) with bleeding, 10 cases(3.87%) with tunnel stenosis, 4 cases(1.55%) with eczema and 15 cases(5.81%) with thrombosis. Conclusion: The main cause of autologous arteriovenous fistula and puncturing is the low immune function, poor hygiene and repeated puncture. Although the buttonhole puncture method improves the success rate of puncture, some complications may occur. After the cause analysis and effective nursing measures, the complications of autologous arteriovenous fistula puncture can be reduced, and the service life of the internal fistula can be prolonged.
引文
[1]Wong B,Muneer M,Wiebe N,et al.Buttonhole versus rope-ladder cannulation of arteriovenous fistulas for hemodialysis:a systematic review[J].Am J Kidney Dis,2014,64(6):918-936.
[2]黄文瑾,刘必成.维持性血液透析患者脂代谢紊乱与心脑血管事件关系的临床研究[J].东南大学学报:医学版,2012,31(6):720-724.
[3]钱文艳,余兢兢,郑金微.钝针扣眼穿刺法降低动静脉内瘘并发症的效果观察[J].护理与康复,2014,13(11)1073-1074.
[4]王芳,徐琴娟,于芳琴.血液透析病人动静脉内瘘扣眼穿刺并发症的原因分析及护理对策[J].全科护理,2016,14(36):3809-3811.
[2]黄文瑾,刘必成.维持性血液透析患者脂代谢紊乱与心脑血管事件关系的临床研究[J].东南大学学报:医学版,2012,31(6):720-724.
[3]钱文艳,余兢兢,郑金微.钝针扣眼穿刺法降低动静脉内瘘并发症的效果观察[J].护理与康复,2014,13(11)1073-1074.
[4]王芳,徐琴娟,于芳琴.血液透析病人动静脉内瘘扣眼穿刺并发症的原因分析及护理对策[J].全科护理,2016,14(36):3809-3811.