中华现代护理杂志
中華現代護理雜誌
중화현대호리잡지
CHINESE JOURNAL OF MODERN NURSING
2012年
34期
4195-4198
,共4页
严贺%金凤兰%童辉%刘慎薇%徐钢
嚴賀%金鳳蘭%童輝%劉慎薇%徐鋼
엄하%금봉란%동휘%류신미%서강
动静脉瘘%扣眼穿刺%穿刺紧张度%穿刺疼痛度
動靜脈瘺%釦眼穿刺%穿刺緊張度%穿刺疼痛度
동정맥루%구안천자%천자긴장도%천자동통도
Arteriovenous fistula%Button-hole puncture%Puncture stress%Puncture-related pain
目的 探讨两种穿刺方法对血液透析患者穿刺难度、患者穿刺紧张度和穿刺疼痛度以及内瘘外观的影响,为血液透析患者内瘘扣眼穿刺的临床应用提供理论依据.方法 将33例自体动静脉内瘘患者分为两个阶段,基础阶段采用绳梯式穿刺,跟踪阶段采用扣眼穿刺,分别记录基础阶段和跟踪阶段的2,3,6,12,18个月的患者重复穿刺次数、穿刺紧张度、穿刺疼痛度、压迫止血时间、渗血次数、感染、动脉瘤形成、血栓形成.结果 (1)与绳梯式穿刺相比,扣眼穿刺后,穿刺难度降低,重复穿刺次数减少,重复穿刺次数从(0.8±1.4)降至(0.3±0.6),差异有统计学意义(t =1.89,P=0.043 8)；(2)与绳梯式穿刺相比,扣眼穿刺能够明显降低患者紧张度,VAS分数从(2.9±2.4)分降至(1.3±1.2)分,差异有统计学意义(t=3.42,P=0.001 0)；(3)扣眼穿刺时穿刺疼痛的VAS评分(1.6±2.0)分相对于绳梯式穿刺的疼痛度(2.3±2.2)分有所减轻,但是差异无统计学意义(t=1.35,P=0.181 0)；(4)扣眼穿刺没有增加压迫止血时间,没有增加发生感染,动脉瘤和血栓的概率,能够有效保护内瘘外观.结论 对于可供穿刺长度较短的、穿刺难度较大的和穿刺紧张度高的动静脉内瘘患者采用扣眼穿刺比目前临床上广泛使用的绳梯式穿刺能够更加有效降低穿刺难度,提高穿刺成功率,降低患者穿刺的紧张度和保护内瘘外观.
目的 探討兩種穿刺方法對血液透析患者穿刺難度、患者穿刺緊張度和穿刺疼痛度以及內瘺外觀的影響,為血液透析患者內瘺釦眼穿刺的臨床應用提供理論依據.方法 將33例自體動靜脈內瘺患者分為兩箇階段,基礎階段採用繩梯式穿刺,跟蹤階段採用釦眼穿刺,分彆記錄基礎階段和跟蹤階段的2,3,6,12,18箇月的患者重複穿刺次數、穿刺緊張度、穿刺疼痛度、壓迫止血時間、滲血次數、感染、動脈瘤形成、血栓形成.結果 (1)與繩梯式穿刺相比,釦眼穿刺後,穿刺難度降低,重複穿刺次數減少,重複穿刺次數從(0.8±1.4)降至(0.3±0.6),差異有統計學意義(t =1.89,P=0.043 8)；(2)與繩梯式穿刺相比,釦眼穿刺能夠明顯降低患者緊張度,VAS分數從(2.9±2.4)分降至(1.3±1.2)分,差異有統計學意義(t=3.42,P=0.001 0)；(3)釦眼穿刺時穿刺疼痛的VAS評分(1.6±2.0)分相對于繩梯式穿刺的疼痛度(2.3±2.2)分有所減輕,但是差異無統計學意義(t=1.35,P=0.181 0)；(4)釦眼穿刺沒有增加壓迫止血時間,沒有增加髮生感染,動脈瘤和血栓的概率,能夠有效保護內瘺外觀.結論 對于可供穿刺長度較短的、穿刺難度較大的和穿刺緊張度高的動靜脈內瘺患者採用釦眼穿刺比目前臨床上廣汎使用的繩梯式穿刺能夠更加有效降低穿刺難度,提高穿刺成功率,降低患者穿刺的緊張度和保護內瘺外觀.
목적 탐토량충천자방법대혈액투석환자천자난도、환자천자긴장도화천자동통도이급내루외관적영향,위혈액투석환자내루구안천자적림상응용제공이론의거.방법 장33례자체동정맥내루환자분위량개계단,기출계단채용승제식천자,근종계단채용구안천자,분별기록기출계단화근종계단적2,3,6,12,18개월적환자중복천자차수、천자긴장도、천자동통도、압박지혈시간、삼혈차수、감염、동맥류형성、혈전형성.결과 (1)여승제식천자상비,구안천자후,천자난도강저,중복천자차수감소,중복천자차수종(0.8±1.4)강지(0.3±0.6),차이유통계학의의(t =1.89,P=0.043 8)；(2)여승제식천자상비,구안천자능구명현강저환자긴장도,VAS분수종(2.9±2.4)분강지(1.3±1.2)분,차이유통계학의의(t=3.42,P=0.001 0)；(3)구안천자시천자동통적VAS평분(1.6±2.0)분상대우승제식천자적동통도(2.3±2.2)분유소감경,단시차이무통계학의의(t=1.35,P=0.181 0)；(4)구안천자몰유증가압박지혈시간,몰유증가발생감염,동맥류화혈전적개솔,능구유효보호내루외관.결론 대우가공천자장도교단적、천자난도교대적화천자긴장도고적동정맥내루환자채용구안천자비목전림상상엄범사용적승제식천자능구경가유효강저천자난도,제고천자성공솔,강저환자천자적긴장도화보호내루외관.
Objective To explore the effect of two puncture methods on the puncture difficulty,puncture ease and puncture-related pain of hemodialysis patients so as to provide theoretical proof for the clinical application of button-hole method.Methods Totals of 33 cases were divided into baseline stage and follow-up stage.In baseline stage,rope-ladder puncture method was applied,and in follow-up stage,button-hole puncture method was used.Repeated puncture times,puncture stress,puncture-related pain,compression time after needle removal,infiltration occurrence after needle removal,infection occurrence,aneurysm formation,thrombosis formation were recorded.Results Compared with rope-ladder puncture,button-hole method decreased puncture difficulty and reduced the repeated puncture times.And the incidence of bad sticks was significantly decreased from (0.8 ± 1.4) to (0.3 ± 0.6),with significant difference (t ＝ 1.89,P =0.043 8).Button-hole method reduced the puncture stress,and the VAS score was reduced from (2.9 ± 2.4) to (1.3 ±1.2),with significant difference (t =3.42,P =0.001 0).Button-hole method abated the puncture-related pain,but no significant difference was found between them [(1.6 ± 2.0) vs (2.3 ± 2.2)],with no difference (t =1.35,P =0.181 0).Button-hole method protected the fistula appearance efficiently,and not increased the infection occurrence,aneurysm formation and thrombosis formation.Conclusions For a patient with a limited space to puncture,or with frequent puncture,or with severe puncture stress,button-hole method is good method,because it can decrease puncture difficulty and reduce repeated puncture times,reduce the puncture stress and protect the fistula appearance efficiently.
