CAJ | 학술논문

目的：为巩固血液透析患者自体动静脉内瘘手术疗效、保证长期安全使用，探讨使用早期科学合理的护理干预措施。方法对83例自体动静脉内瘘使用早期，实施护理干预：①穿刺前进行内瘘血管评估；②开始使用时由有经验的护士选择内瘘肘部头静脉或贵要静脉作为引血通路进行穿刺；③提高护士技能，养成良好工作习惯，预防并发症及早期处置④给予患者健康指导，提高自我护理技能。结果本中心83例AVF患者无感染发生，1例糖尿病肾病顽固性低血压患者规律透析25月后出现血管狭窄至闭塞，目前内瘘使用已达36月10例、24-36月24例、12-24月32例、不足12月16例，透析血流量均达到210至300ml/min，功能良好。结论对血液透析患者自体动静脉内瘘实施早期护理干预，能促进内瘘成熟,提高造瘘成率，对防治并发症,延长内瘘使用寿命起重要作用。
목적：위공고혈액투석환자자체동정맥내루수술료효、보증장기안전사용，탐토사용조기과학합리적호리간예조시。방법대83례자체동정맥내루사용조기，실시호리간예：①천자전진행내루혈관평고；②개시사용시유유경험적호사선택내루주부두정맥혹귀요정맥작위인혈통로진행천자；③제고호사기능，양성량호공작습관，예방병발증급조기처치④급여환자건강지도，제고자아호리기능。결과본중심83례AVF환자무감염발생，1례당뇨병신병완고성저혈압환자규률투석25월후출현혈관협착지폐새，목전내루사용이체36월10례、24-36월24례、12-24월32례、불족12월16례，투석혈류량균체도210지300ml/min，공능량호。결론대혈액투석환자자체동정맥내루실시조기호리간예，능촉진내루성숙,제고조루성솔，대방치병발증,연장내루사용수명기중요작용。
Objective to consolidate hemodialysis patients with autogenous arteriovenous internal fistula surgical curative effect, ensure the safety of long-term use, discusses the nursing intervention measures of early use of scientific and reasonable.Methods With the nursing intervention to 83 cases of early autogenous arteriovenous fistula in use:①estimate the fistula blood vessels before the assessment; ② Began to use by an experienced nurse with 17 g needle puncture, choose the internal fistula elbow cephalic vein or expensive to venous blood as a guide path; ③ improve Nursing skil s, develop good working habits; ④ give patients health guidance, avoid and reduce the complications occurred in fistula. Results In our center, 83 AVF patients without infection, 1 case of diabetic nephropathy patients with refractory hypotension , hemal stricture and occlusion after 25 months regular dialysis, 10 cases of internal fistula is used currently has 36 months, 24 to 36 months 24 cases, 12 to 24 months December 16 cases, 32 cases, inadequate dialysis, blood flow are for 210 to 300 ml/min, function is good. Conclusions early nursing intervention to autogenous arteriovenous fistula in hemodialysis patients can promote internal fistula maturity, improve the success rate of fistula, and play an important role in the prevention and treatment of complications, prolonging the service life of internal fistula.