CAJ | 학술논문

目的：探讨喜疗妥外涂联合远红外线照护对血液透析患者内瘘护理后初次使用率及透析血流量的影响。方法选取75例血液透析自体动静脉内瘘护理患者，内瘘术后采用传统法局部喜疗妥外涂护理的35例患者为传统组，而采用改良法喜疗妥外涂联合远红外线照护的40例患者为改良组，比较两种不同内瘘护理效果。结果改良组护理有效率为95．00％，高于传统组的48．57％，差异有统计学意义（χ2＝6．08，P＜0．05）；改良组血管内径、壁厚分别为（5．56±0．37），（0．63±0．07）mm，优于传统组（5．01±0．21），（0．54±0．04）mm，差异有统计学意义（t值分别为2．65，2．71；P＜0．05）；改良组术后4周透析血流量（239．04±35．43）ml大于初次透析血流量（210．31±35．42）ml，差异有统计学意义（t＝3．85， P＜0．05）；改良组血流量不足、血管狭窄、血肿发生率分别为0．00％，5．00％，2．50％，低于传统组的28.57％，20．00％，20．00％，差异有统计学意义（χ2值分别为4．03，3．96，3．99；P＜0．05），血管栓塞发生率改良组为0．00％，传统组为8．57％，组间比较差异无统计学意义（χ2＝2．01，P＞0．05）。结论改良法内瘘护理通过促进内瘘成熟，改善内瘘纤维化及血管弹性等途径达到理想的透析血流量，可延长使用时间及减少并发症，提高患者生活质量，值得临床推广使用。
목적：탐토희료타외도연합원홍외선조호대혈액투석환자내루호리후초차사용솔급투석혈류량적영향。방법선취75례혈액투석자체동정맥내루호리환자，내루술후채용전통법국부희료타외도호리적35례환자위전통조，이채용개량법희료타외도연합원홍외선조호적40례환자위개량조，비교량충불동내루호리효과。결과개량조호리유효솔위95．00％，고우전통조적48．57％，차이유통계학의의（χ2＝6．08，P＜0．05）；개량조혈관내경、벽후분별위（5．56±0．37），（0．63±0．07）mm，우우전통조（5．01±0．21），（0．54±0．04）mm，차이유통계학의의（t치분별위2．65，2．71；P＜0．05）；개량조술후4주투석혈류량（239．04±35．43）ml대우초차투석혈류량（210．31±35．42）ml，차이유통계학의의（t＝3．85， P＜0．05）；개량조혈류량불족、혈관협착、혈종발생솔분별위0．00％，5．00％，2．50％，저우전통조적28.57％，20．00％，20．00％，차이유통계학의의（χ2치분별위4．03，3．96，3．99；P＜0．05），혈관전새발생솔개량조위0．00％，전통조위8．57％，조간비교차이무통계학의의（χ2＝2．01，P＞0．05）。결론개량법내루호리통과촉진내루성숙，개선내루섬유화급혈관탄성등도경체도이상적투석혈류량，가연장사용시간급감소병발증，제고환자생활질량，치득림상추엄사용。
Objective To explore the effect of hiru doid combined far infrared ray on hemodialysis flow for hemodialysis fistula patients at first used .Methods Chosen 75 hemodialysis fistula patients and divied two groups.Traditional group (n=35) accepted the traditional hirudoid method after fistula operation , improved group (n=40) received hirudoid combined far infrared ray;research would compare the results of nursing care between two groups.Results The research showed the effective rate of nursing care was 95.00% in improved group,and was 48.57%in traditional group, the differences had statistical significance (χ2 =6.08,P<0.05);the vasal inner diameter and vasal thickness of improved group were (5.56 ±0.37)mm and (0.63 ±0.07)mm, and were (5.01 ±0.21),(0.54 ±0.04)mm of traditional group, the differences had statistical significance (t=2.65,2.71, respectively;P<0.05);hemodialysis flow 4 weeks after operation of improve group was (239.04 ± 35.43) ml , first used patients was(210.31 ±35.42)ml, the differences had statistical significance (t =3.85, P <0.05 ).Moreover, the improved group also contributed to the blood flow volume , angiostegnosis, hematoma.The rate of blood flow volume shortage , angiostegnosis, hematoma were 0.00%,5.00%,2.50%, comparing with 28.57%,20.00%,20.00%in traditional group, the differences had statistical significance (χ2 =4.03,3.96,3.99, respectively;P<0.05).However, the rate of thrombosis were 0.00% (improved group) and 8.57%( traditional group ) (χ2 =2.01, P >0.05 ).Conclusions Improved group advanced the hemodialysis flow by promoting fistula becoming mature , vasoactivity and fistula fibrillation , and reduced clinical complications and enhanced patients'the quality of life .