中国医学创新
中國醫學創新
중국의학창신
MEDICAL INNOVATION OF CHINA
2013年
28期
6-7,8
,共3页
李文秀%温玉%潘玮瑛%叶琼玉%曾春兰%王燕%谢祝君
李文秀%溫玉%潘瑋瑛%葉瓊玉%曾春蘭%王燕%謝祝君
리문수%온옥%반위영%협경옥%증춘란%왕연%사축군
血液透析%内瘘血管%疼痛%Kt/V
血液透析%內瘺血管%疼痛%Kt/V
혈액투석%내루혈관%동통%Kt/V
Blood dialysis%Internal fistula blood vessels%Pain%Kt/V
目的：比较血液透析中血液流速超过病员体重4倍与血液流速不超过病员体重4倍，改进的动脉端针尖向心方向穿刺与传统的逆心方向穿刺对透析效果和内瘘血管的影响。方法：选取2012年4-11月在本院采取内瘘血管穿刺行维持性血液透析的尿毒症病员，共采血样594份，随机分为观察组和对照组。观察组采用血液流速超过病员体重4倍，观察组1与观察组2分别采用向心与逆心方向穿刺；对照组采用血液流速不超过病员体重4倍，对照组1与对照组2分别采用向心与逆心方向穿刺，四组透析次数均为2~3次/周，比较Kt/V值、内瘘穿刺成功率与病员的疼痛感。结果：观察组病员Kt/V值优于对照组，观察组1与观察组2透析后Kt/V值基本相同，对照组1与对照组2透析后Kt/V值基本相同，改进的穿刺方法，穿刺成功率高，病员疼痛感轻。结论：采用改进的血液流速超过病员体重4倍，对毒素的清除效果大于采用血液流速不超过病员体重4倍，改进的动脉端针尖向心方向穿刺不影响透析效果，保护了内瘘血管，减轻了病员的痛苦。
目的：比較血液透析中血液流速超過病員體重4倍與血液流速不超過病員體重4倍，改進的動脈耑針尖嚮心方嚮穿刺與傳統的逆心方嚮穿刺對透析效果和內瘺血管的影響。方法：選取2012年4-11月在本院採取內瘺血管穿刺行維持性血液透析的尿毒癥病員，共採血樣594份，隨機分為觀察組和對照組。觀察組採用血液流速超過病員體重4倍，觀察組1與觀察組2分彆採用嚮心與逆心方嚮穿刺；對照組採用血液流速不超過病員體重4倍，對照組1與對照組2分彆採用嚮心與逆心方嚮穿刺，四組透析次數均為2~3次/週，比較Kt/V值、內瘺穿刺成功率與病員的疼痛感。結果：觀察組病員Kt/V值優于對照組，觀察組1與觀察組2透析後Kt/V值基本相同，對照組1與對照組2透析後Kt/V值基本相同，改進的穿刺方法，穿刺成功率高，病員疼痛感輕。結論：採用改進的血液流速超過病員體重4倍，對毒素的清除效果大于採用血液流速不超過病員體重4倍，改進的動脈耑針尖嚮心方嚮穿刺不影響透析效果，保護瞭內瘺血管，減輕瞭病員的痛苦。
목적：비교혈액투석중혈액류속초과병원체중4배여혈액류속불초과병원체중4배，개진적동맥단침첨향심방향천자여전통적역심방향천자대투석효과화내루혈관적영향。방법：선취2012년4-11월재본원채취내루혈관천자행유지성혈액투석적뇨독증병원，공채혈양594빈，수궤분위관찰조화대조조。관찰조채용혈액류속초과병원체중4배，관찰조1여관찰조2분별채용향심여역심방향천자；대조조채용혈액류속불초과병원체중4배，대조조1여대조조2분별채용향심여역심방향천자，사조투석차수균위2~3차/주，비교Kt/V치、내루천자성공솔여병원적동통감。결과：관찰조병원Kt/V치우우대조조，관찰조1여관찰조2투석후Kt/V치기본상동，대조조1여대조조2투석후Kt/V치기본상동，개진적천자방법，천자성공솔고，병원동통감경。결론：채용개진적혈액류속초과병원체중4배，대독소적청제효과대우채용혈액류속불초과병원체중4배，개진적동맥단침첨향심방향천자불영향투석효과，보호료내루혈관，감경료병원적통고。
Objective:To compare with hemodialysis in blood flow than patient weight 4 times,and not more than 4 times patient weight blood flow,and between improved arterial end tip piercing the centripetal direction and the traditional inverse direction of heart puncture of dialysis fistula blood vessels inside the effect and influence.Method:Uremic patients with maintenance hemodialysis by taken internal fistula vascular puncture from April 2012 to November 2012 in hospital were selected,altogether collected blood samples of 594,and were randomly divided into the observation group and the control group;the observation group was treated with blood flow more than the weight of 4 times,the observation group 1 and group 2 were punctured by the direction of the heart and inverse respectively.In the control group was treated with the blood velocity of not more than 4 times patient weight,the control group 1 and group 2 were punctured by the direction of the heart and inverse direction respectively.The numbers of dialysis were 2-3 times per week. Then Kt/V value,success rate of internal fistula puncture and patient’s pain among four groups were compared.Result:The Kt/V value of observation group patients was better than that of control group,and Kt/V value was basically the same after dialysis between the observation group 1 and group 2.The control group 1 and group 2 Kt/V value was basically the same after dialysis.The improved puncture method had higher success rate of puncturing and less patient pain.Conclusion:According to effect of scavenging the toxin,the method of improved blood flow velocity more than patient weight 4 times is better than using stents weight not more than 4 times the blood flow velocity.Improved arterial end tip piercing the centripetal direction does not affect the dialysis effect,but may protect the internal fistula blood vessels,and reduces patient’s pain.
