护理干预法对血液透析患者动静脉内瘘钝针瘘道形成的影响

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摘要目的探讨护理干预法对血液透析患者动静脉内瘘钝针瘘道形成的影响。方法选取2016年2月至2018年2月厦门市中医院收治的260 例动静脉内瘘术后血液透析+钝针穿刺患者作为研究对象，采用信封随机化法分为观察组（140 例）与对照组（120 例）。观察组采用护理干预法，同一护理人员为患者穿刺，对照组采用常规护理，根据护理人员上班时间为患者安排穿刺。比较两组的钝针瘘道形成时间、不同去痂方法、穿刺3 次、钝针瘘道形成的疼痛评分、穿刺前后的焦虑、抑郁评分。结果观察组的钝针瘘道形成时间短于对照组，差异有统计学意义（P＜0.05）。观察组的形成瘘道穿刺次数少于对照组，差异有统计学意义（P＜0.05）；观察组温无菌生理盐水棉球湿敷后去痂用时短于对照组，差异有统计学意义（P＜0.05）；观察组穿刺3 次的疼痛评分低于对照组，差异有统计学意义（P＜0.05）；观察组的钝针瘘道形成时疼痛评分低于对照组，差异有统计学意义（P＜0.05）。两组穿刺前的焦虑、抑郁评分比较，差异无统计学意义（P＞0.05），观察组穿刺后的焦虑、抑郁评分低于对照组，差异均有统计学意义（P＞0.05）。结论护理干预法有利于调节患者钝针瘘道形成阶段存在的不良情绪；通过温无菌生理盐水棉球湿敷，去痂效果更显著；由同一护理人员穿刺，能缩短血液透析患者动静脉内瘘钝针瘘道的形成时间。

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	吴丽丹
	蔡丽娜

关键词 ：护理干预, 血液透析, 动静脉内瘘, 钝针瘘道, 影响分析

Abstract：Objective To investigate the influence of nursing intervention on the formation of blunt needle fistula in arteriovenous internal fistula in hemodialysis patients. Methods A total of 260 patients with hemodialysis+blunt needle puncture afterarteriovenous internal fistula admitted to Xiamen Hospital of Traditional Chinese Medicine from February 2016 to February 2018 were selected as the research objects. By envelope randomization, they were divided into the observation group (140 cases) and the control group (120 cases). The observation group was given intervention, was punctured by the same nursing staff, while the control group was given routine nursing, was punctured according to the working hours of nursing staff. The formation time of blunt needle fistula, different methods of scab removal, three times of puncture, pain score of blunt needle fistula formation, anxiety and depression scores before and after puncture were compared between the two groups. Results The formation time of blunt needle fistula in observation group was shorter than that in control group, and the difference was statistically significant (P＜0.05). The number of fistula puncture in observation group was less than that in control group, and the difference was statistically significant (P＜0.05). The scab removal time in the observation group was shorter than that in the control group after wet application of warm sterile normal saline cotton ball, and the difference was statistically significant (P＜0.05). The pain score of the observation group was lower than that of the control group after three puncture times, and the difference was statistically significant(P＜0.05). The pain score of blunt needle fistula formation in the observation group was lower than that in the control group, and the difference was statistically significant (P＜0.05). Before puncture, there were no significant difference in anxiety and depression scores between the two groups (P＞0.05). After puncture, anxiety and depression scores in the observation group were lower than those in the control group, with statistical differences (P＜0.05）. Conclusion Nursing intervention is helpful to regulate the bad mood of patients in the formation stage of blunt needle fistula; the effect of eschar removal is more significant by wet application of warm sterile saline cotton ball; the formation time of arteriovenous fistula in hemodialysis patients can be shortened by puncturing by a nursing staff

Key words： Nursing intervention Hemodialysis Arteriovenous fistula Blunt needle fistula Impact analysis

引用本文:

吴丽丹；蔡丽娜. 护理干预法对血液透析患者动静脉内瘘钝针瘘道形成的影响[J]. 中国当代医药, 2021, 28(30): 220-223.
WU Li-dan；CAI Li-na. Effect of nursing intervention on arteriovenous fistula formation in hemodialysis patients. 中国当代医药, 2021, 28(30): 220-223.

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http://dangdaiyiyao.com/CN/ 或 http://dangdaiyiyao.com/CN/Y2021/V28/I30/220

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