摘要
目的对比钝针扣眼穿刺法和锐针绳梯穿刺法对维持性血液透析患者自体动静脉内瘘功能状态的临床效果。方法选取2015年4月~2016年10月于我院血液净化中心采用动静脉内瘘作为血管通路行血液透析的患者共70例,按随机数字表法分为对照组(35例)和观察组(35例),对照组给予锐针绳梯穿刺,观察组应用钝针扣眼穿刺,比较两组患者穿刺成功率、渗血率、并发症发生率及疼痛程度。结果观察组穿刺成功率显著高于对照组,差异有统计学意义(P<0.05);观察组渗血率及血栓形成、血管狭窄、动脉瘤的发生率显著显著低于对照组,差异有统计学意义(P<0.05);而在感染发生率方面,差异无统计学意义(P>0.05);观察组穿刺后无痛、轻度疼痛、中度疼痛及重度程度发生率均显著低于对照组,差异有统计学意义(P<0.05);结论钝针扣眼穿刺法比锐针绳梯穿刺法更能提高穿刺的成功率,降低穿刺点渗血,预防并发症的发生,减轻患者的疼痛,值得临床推广。
Objective To compare the clinical effects of blunt needle buttonhole puncture and sharp needle ladder puncture on maintaining functional status of autologous arteriovenous fistula in maintenance hemodialysis patients. Methods 70 patients who underwent hemodialysis with arteriovenous fistula as the vascular access in the blood purification center of our hospital from April 2015 to October 2016 were selected.They were divided into the control group and the observation group according to random number table method,with 35 cases in each group.The control group was given sharp needle ladder puncture while the observation group was given blunt needle buttonhole puncture. Success rate of puncture,blood oozing rate,incidence of complications and pain level of two groups were compared. Results The success rate of puncture in the observation group was significantly higher than that in the control group and the difference was statistically significant (P < 0.05).Blood oozing rate and the incidence of thrombosis,vascular stenosis and aneurysm n the observation group were significantly lower than those in the control group,and the difference was statistically significant (P < 0.05).There was no significant difference in the incidence of infection between the two groups (P > 0.05).The incidence of painless,mild pain,moderate pain and severity in the observation group was significantly lower than the control group,and the difference was statistically significant(P < 0.05). Conclusion Compared with sharp needle ladder puncture,blunt needle buttonhole puncture can improve the success rate of puncture,reduce the blood oozing at the puncture point,prevent the occurrence of complications and alleviate the pain of patients,which is worthy of clinical promotion.
作者
阳美芬
郭小卫
钟芳萍
YANG Meifen;GUO Xiaowei;ZHONG Fangping(Department of Nephrology,Longhua District People’s Hospital of Shenzhen,Guangdong,Shenzhen 518109,China;Hemodialysis Room,Guangdong Provincial Hospital of Traditional Chinese Medicine,Guangdong,Shenzhen 518109,China)
出处
《中国医药科学》
2019年第13期172-174,共3页
China Medicine And Pharmacy
基金
深圳市卫生计划系统科研项目(2017022)
关键词
钝针扣眼穿刺
锐针绳梯穿刺
血液透析
动静脉内瘘
Blunt needle buttonhole puncture
Sharp needle ladderpuncture
Hemodialysis
Arteriovenous fistula
