摘要
①目的探讨维持性血液透析患者动静脉内瘘穿刺中血管穿透伤并发皮下血肿的预防和护理。②方法回顾性分析2009年2月～2014年1月705例维持性血液透析行动静脉内瘘穿刺患者护理资料,作为观察组。预防方法为：选择合适的透析时间,促进内瘘的成熟;把握合适的穿刺时机和穿刺血管,加强穿刺技巧;妥善处理并发症（冰敷、硫酸镁热敷联合芦荟外敷）等。选取2005年1月～2009年1月行常规护理的1830例维持透析患者,作为对照组。对两组动静脉内瘘血管穿透伤并发皮下血肿发生率进行比较。③结果对照组1830例维持透析常规护理患者,动静脉内瘘血管穿透伤并发皮下血肿发生率为1.37%（25/1830）,其中3例发生静脉血栓,1例发生动脉端穿透伤,均经治疗后好转。观察组705例患者动静脉内瘘血管穿透伤并发皮下血肿发生率为0.28%（2/705）。观察组动静脉内瘘血管穿透伤并发皮下血肿发生率显著低于对照组,差异有统计学意义（P〈0.05）。④结论有效预防和精心护理能够降低动静脉内瘘穿刺过程中内瘘血管穿透伤合并皮下血肿的发生,减轻患者的痛苦,延长内瘘的使用时间,提高血液透析患者的生命质量。
Objective To investigate the prevention and care of vascular penetrating trauma complicated by hematoma in arteriovenous fistula puncture of hemodialysis patients.Methods The care informations of 705 hemodialysis patients treated by arteriovenous fistula puncture from February 2009 to January 2014 were retrospectively analyzed.Patients were denoted into observation group, the methods of prevention（appropriate duration of dialysis selecting,fistula maturationp Promoting,right timing and vascular puncture puncture selecting, puncture technique strengthening, and properly fixed） and complications care（ice compresses, magnesium sulfate heat compresses combined aloe vera topicalcompresses） were summarized.And 1830 hemodialysis patients with routine care from January 2005 to January 2009 were denoted as control group.Arteriovenous fistula vessels penetrating trauma complicated with subcutaneous hematoma rate of two groups were compared.Results In control group of 1830 cases,arteriovenous fistula vessels penetrating trauma complicated with subcutaneous hematoma rate was 1.37% （25/ 1830）, of which three cases was venous thrombosis, 1 case was arterial end penetrating wounds,all were improved after treatment.705 cases in observation group arteriovenous fistula vessels penetrating trauma complicated with subcutaneous hematoma rate was 0.28%（2/705）.Arteriovenous fistula blood vessels penetrating trauma complicated with subcutaneous hematoma rate of observation group was significantly lower than control group,the difference was statistically significant（ P 〈0.05）.Conclusion Effective prevention and intensive care can reduce arteriovenous fistula vessels penetrating trauma complicated with subcutaneous hematoma rate,alleviate the suffering of patients, extend the life of fistula ,nd improve the life quality of hemodialysis patients.
出处
《河北联合大学学报（医学版）》
2016年第1期59-61,共3页
Journal of North China Coal Medical College
基金
唐山市科技支撑项目(编号:10130265A)
关键词
血液透析
动静脉内瘘
穿透伤
皮下血肿
护理
Hemodialysis. Arteriovenous fistula. Penetrating wounds. Subcutaneous hematoma. Care
