摘要
目的探究超声下经皮静脉球囊扩张术(percutaneous venous balloon angioplasty,PTA)联合规范化管理在动静脉内瘘(arteriovenous fistula,AVF)狭窄中的应用。方法选取2021年2月至2023年2月赣南医学院第一附属医院收治的100例尿毒症AVF狭窄患者作为研究对象,根据干预方案的不同随机分为观察组与对照组,各50例。对照组予以超声下PTA治疗,观察组在对照组基础上联合规范化围期管理干预。比较两组临床治疗成功率、手术成功率、狭窄处内径、峰值流速、透析血流量、生命质量、护理满意度及术后并发症发生情况。结果两组手术成功率比较差异无统计学意义;观察组临床治疗成功率高于对照组,差异有统计学意义(P<0.05)。术后即刻、术后1个月,两组峰值流速均快于治疗前,狭窄处内径均长于治疗前,透析血流量均多于治疗前,术后1个月,对照组峰值流速快于术后即刻,狭窄处内径短于术后即刻,透析血流量少于术后即刻,观察组狭窄处内径短于术后即刻,差异有统计学意义(P<0.05),两组内其余时间点两两比较差异无统计学意义;术后1个月,观察组峰值流速慢于对照组,狭窄处内径长于对照组,透析血流量多于对照组,差异有统计学意义(P<0.05),两组间其余时间点两两比较差异无统计学意义。治疗后,两组躯体疼痛、活力、社会功能、情感职能、生理机能、总体健康状况、生理职能及精神健康均高于治疗前,且观察组高于对照组,差异有统计学意义(P<0.05)。观察组护理满意度高于对照组,差异有统计学意义(P<0.05)。观察组并发症发生率低于对照组,差异有统计学意义(P<0.05)。结论超声下PTA联合规范化管理在AVF狭窄应用中可显著改善患者生命质量,提高护理满意度,减少并发症发生,值得临床推广应用。
Objective To explore the application of ultrasound-guided percutaneous venous balloon angioplasty(PTA)combined with standardized management in arteriovenous fistula(AVF)stenosis.Methods 100 patients with uremic AVF stenosis admitted to the First Affiliated Hospital of Gannan Medical College from February 2021 to February 2023 were selected as the research subjects,they were randomly divided into the observation group and the control group according to the different intervention schemes,with 50 cases in each group.The control group was treated with PTA under ultrasound,and the observation group was combined with standardized management on the basis of the control group.The clinical treatment success rate,surgical success rate,stenosis diameter,peak flow rate,dialysis blood flow,quality of life,nursing satisfaction and postoperative complications were compared between the two groups.Results There was no significant difference in the success rate between the two groups,the success rate of clinical treatment in the observation group was higher than that in the control group,the differences were statistically significant(P<0.05).Immediately after operation and 1 month after operation,the peak flow velocity of the two groups was faster than that before treatment,the inner diameter of the stenosis was longer than that before treatment,and the dialysis blood flow was more than that before treatment,at 1 month after operation,the peak flow velocity in the control group was faster than that immediately after operation,the inner diameter of the stenosis was shorter than that immediately after operation,the dialysis blood flow was less than that immediately after operation,and the inner diameter of the stenosis in the observation group was shorter than that immediately after operation,the difference was statistically significant(P<0.05),there was no significant difference between the two groups at other time points;at 1 month after operation,the peak flow rate in the observation group was slower than that in the control group,the inner diameter of the stenosis was longer than that in the control group,and the dialysis blood flow was more than that in the control group,the differences were statistically significant(P<0.05),and there was no significant difference between the two groups at other time points.After treatment,the physical pain,vitality,social function,emotional function,physiological function,overall health status,physiological function and mental health of the two groups were higher than those before treatment,and those in the observation group were higher than the control group,the differences were statistically significant(P<0.05).The nursing satisfaction in the observation group was higher than that in the control group,and the difference was statistically significant(P<0.05).The incidence of complications in the observation group was lower than that in the control group,the difference was statistically significant(P<0.05).Conclusion Ultrasound-guided PTA combined with standardized management in the application of AVF stenosis can significantly improve the quality of life of patients,improve nursing satisfaction,and reduce complications,and is worthy of clinical promotion and application.
作者
刘书凤
左栋年
邹芳琴
罗娟
段丽娜
赖剑
LIU Shufeng;ZUO Dongnian;ZOU Fangqin;LUO Juan;DUAN Li'na;LAI Jian(Department of Nephrology,First Affiliated Hospital of Gannan Medical College,Ganzhou,Jiangxi,341000,China;Department of Internal Medicine,Second Affiliated Hospital of Quannan County,Ganzhou,Jiangxi,341800,China;Department of Gastroenterology,First Affiliated Hospital of Gannan Medical College,Ganzhou,Jiangxi,341000,China)
出处
《当代医学》
2024年第19期108-112,共5页
Contemporary Medicine
基金
江西省卫生健康委科技计划项目(202310257)
赣州市卫生健康委员会市级科研计划项目(2022-2-061)。
关键词
经皮静脉球囊扩张术
规范化管理
动静脉内瘘狭窄
Percutaneous venous balloon angioplasty
Standardized management
Arteriovenous fistula stenosis
