摘要
目的 监测血液透析患者不同血管通路再循环的情况,并分析其相关因素,便于实施护理对策。方法 采用Transonic HD02血液透析监测仪分别对2013年1月~2015年5月在我院行血液透析的118例血液透析患者不同血管通路正接及反接时进行再循环的监测,并分析可能影响血液透析患者再循环的相关因素。结果 不同血管通路正接时,其再循环情况比较,差异无统计学意义（P〉0.05）。不同血管通路反接时,动静脉内瘘（AVF）再循环情况较颈静脉管及股静脉管的再循环率低,三者比较差异有统计学意义（P〈0.05）。其中,动静脉内瘘管与颈静脉管或股静脉管两两比较,差异有统计学意义（P〈0.05）;颈静脉管与股静脉管比较,无统计学意义（P〉0.05）。动-静脉内瘘（AVF）顺穿或反穿时,A-V间距〈5cm其再循环情况较A-V间距〉5cm高,两者比较差异有统计学意义（P〈0.05）。结论 进行血液透析时,最好建立动静脉内瘘,进行AVF穿刺时,A-V间距尽量相差5cm或以上,以减少再循环发生率。在AVF不能使用时,可以建立临时血管通路,即颈静脉管或股静脉留置管,但是尽量避免反接,以减少再循环率。
Objective To measure the condition of different vascular access recirculation in hemodialysis patients and to analysis their relative factors,then to facilitate the implementation of nursing countermeasures. Methods 118 cases of hemodialysis blood dialysis patients given hemodialysis in our hospital from January 2013 to May 2015 were carried on different vascular access and reverse connection of recirculation monitoring by Transonic HD02 hemodialysis monitors respectively.The related factors that may influence the recycling of hemodialysis patients were analyzed. Results The comparison of measurement of access recirculation was showed no statistically significant difference （P 〉 0.05） when the different vascular access was lined normally. Rccirculation rate of AVF was lower than the internal jugular or femoral vein （P 〈 0.05）,they had statistically significant difference.But comparison of the internal jugular vein and femoral vein showed no statistically significant difference （P 〉0.05）.When AVF was normal or reversed,recirculation was higher A-V distance 〈 5cm than A-V distance 〉 5era,they had statistically significant difference （P 〈 0.05）. Conclusion AVF is the best choice when hemodialysis,A-V distance must he 5cm or more,so it can reduce recirculation rate.When AVF can＇ t be used,the temporary vascular access can be made,such as the internal jugular or femoral vein,hut it must avoid reversed lines,reducing the recirculation rate.
出处
《中国医药科学》
2016年第16期183-185,共3页
China Medicine And Pharmacy
关键词
再循环
血液透析
血管通路
因素分析
Recirculation
Hemodialysis
Vascular access
Relative factors
