摘要
目的:通过采用扣眼穿刺的方法来降低自体动静脉内瘘的并发症且延长其使用寿命。方法:由高年资经验丰富且相对固定的护士,遵循三同原则,做好扣眼穿刺前的有效护患沟通,自体动静脉内瘘的评估,穿刺后导管的固定,透析过程中渗血情况的处理,及结束后的相关护理宣教。结果:12例患者经过8~12次应用常规锐针穿刺后形成皮下隧道即扣眼,2例糖尿病肾病的患者在锐针穿刺12次以上才形成皮下隧道,有1例患者因由不同护士穿刺建立的隧道,出现硬结5个月后隧道闭塞。13例患者均未出现内瘘狭窄、血管瘤、血栓、内瘘感染等并发症。结论:采用钝针进行扣眼穿刺法是透析患者自体动静脉内瘘最为理想的穿刺方式,能够有效降低自体动静脉内瘘的并发症延长其使用年限,提高患者的透析质量。
Objective ： To reduce the complications of autogenous arteriovenous fistula with buttonhole puncture method and increase its service life. Methods ： The senior and relatively fixed nurses with rich experience effectively communicated with the patients and educated them on the evaluation of autogenous ar- teriovenous fistula, fixing of catheter after puncture, errhysis in the process of hemodialysis and relevant nursing after that by comply with three principles. Results ： Subcutaneous tunnel （buttonhole） ＇was formed in 12 patients after 8 - 12 times of conventional sharp needle puncture, the subcutaneous tunnel was formed only after more than 12 times of sharp needle puncture for 2 patients of diabetic nephropathy, and tunnel blockage after 5 months of induration was formed in 1 patient due to the tunnel punctured by different nurses. No complications such as fistuk stenosis, hemangioma, thrombus and intemal fistula in- fection occurred to the 13 patients. Conclusion ：The use of blunt needle for buttonhole puncture was the most ideal puncture method for the autogenous arteri- ovenous fistula of hemodialysis patients, which could effectively reduce the complications of autogenous arteriovenous fistula, extend its service life and im- prove the patients＇ hemodialysis quality.
作者
董士起
DONG Shi -qi(Tianjin Haihe Hospital,Tianjin 30035)
出处
《护理实践与研究》
2017年第1期137-138,共2页
Nursing Practice and Research
关键词
钝针扣眼穿刺法
自体动静脉内瘘
护理
Blunt needle for buttonhole puncture method
Autogenous arteriovenous internal fistula：Nursing
