摘要
目的比较三点定位法和传统穿刺法在血液透析患者动静脉内瘘中的应用效果其临床价值。方法将800例血液透析患者随机分为三点定位法穿刺(观察组)和传统穿刺法穿刺(对照组),每组各400例,所有穿刺均由资深护士执行,应用彩色多普勒分别观测穿刺前、穿刺60次后动静脉内瘘血管内膜壁的厚度,对比2组的穿刺失败率、动静脉内瘘动脉瘤发生状况、动静脉内瘘狭窄发生状况及患者满意度。结果 2组患者穿刺前后的动静脉内瘘血管内壁厚经比较差异有统计学意义(P<0.05);观察组患者治疗后对动静脉内瘘血管内膜壁的厚度的影响程度显著低于对照组(P<0.05);观察组患者穿刺60次的穿刺失败率、动静脉内瘘动脉瘤发生率、动静脉内瘘狭窄发生率显著低于对照组(P<0.05);观察组患者满意度显著高于对照组(P<0.05)。结论三点定位穿刺法联合氯沙坦的应用在血液透析患者动静脉内瘘中的临床效果较好,可以有效延长穿刺血管的使用寿命,降低血透内瘘血管并发症的发生率。
Objective To compare the effect of three-point positioning method and traditional puncture method in patients with arteriovenous fistula in hemodialysis. Methods A total of 800 hemo- dialysis patients with malignant tumor of urinary system in our hospital were divided into three-point positioning method group （observation group） and traditional puncture method group （control group）, with 400 cases in each group. All the puncture was performed by the senior nurses with color Doppler, and vein intima thickness of artery fistula before puncture and 60 times after puncture were observed, puncture failure rate, incidence of venous fistula aneurysm, arteriovenous fistula stenosis and satisfac- tion were compared. Results There was no significant difference in vein intima thickness of artery fis- tula （ P 〈 0.05 ） ; The effect degree of vein intima thickness of artery fistula in the observation group af- ter treatment was significantly lower than that of the control group, and the difference was statistically signifieant（P 〈 0.05 ）; The puncture failure rate, incidence of arteriovenous fistula aneurysm, and arteriovenous fistula stenosis rate in the observation group after 6 0 times puncture were significantly lower than that in the control group, and the differences were statistically significant （ P 〈 0.0 5 ） ; The satisfaction in the observation group was significantly higher than that in the control group, the difference was statistically significant （ P 〈 0.05 ）. Conclusion Three-point positioning puncture combined with losartan has significant effect for arteriovenous fistula patients with the malignant tumor of urinary system, and it can effectively prolong longevity of vascular puncture, and reduce complications of vascular with fistula.
出处
《实用临床医药杂志》
CAS
2017年第16期37-39,共3页
Journal of Clinical Medicine in Practice
基金
山东省自然科学基金资助项目(Y2006C02)
关键词
三点定位穿刺法
血液透析
动静脉内瘘
氯沙坦
three-point positioning method
hemodialysis
malignant tumor of urinary system
arteriovenous fistula
losartan
