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目的:分析两种穿刺方法对动静脉内瘘的并发症和患者疼痛的影响。方法:选择我院2015年3月-2017年3月期间我院行维持性血液透析治疗的44例患者为分析对象,均分为甲乙两组各22例,甲组患者采用常规针尖斜面向上穿刺,穿入血管后缓慢平行推入,针柄贴皮肤固定穿刺针。乙组患者采用穿刺时将针尖斜面稍倾斜20°穿入血管,穿入血管后斜面向上缓慢进针,迅速将针翻转180°,斜面向下缓慢进针,达到需要的深度,将针翻转180°,固定穿刺针在穿刺时的角度或与穿刺时接近的角度。对比两组内瘘并发症发生情况及患者疼痛程度。结果:乙组动静脉内瘘血管瘤、狭窄及闭塞等并发症发生率均低于甲组,且乙组疼痛程度低于甲组,两组各项结果对比差异有统计学意义。结论:对维持性血液透析患者采用乙组穿刺方法,可有效保护动静脉内瘘,减少内瘘并发症发生,缓解穿刺时疼痛,提高患者透析治疗效果。
Objective: To analyze the effects of two methods of puncture on the complications of arteriovenous fistula and the pain of patients. Methods: Forty-four patients undergoing maintenance hemodialysis in our hospital from March 2015 to March 2017 were divided into two groups (arm A and arm B, 22 cases each). Patients in arm A , Penetrate slowly into the blood vessels after the penetration, the needle stick to the skin fixed puncture needle. Group B patients puncture the needle tip bevel slightly tilted 20 ° into the blood vessels, into the blood vessels after the bevel upward slowly into the needle, the needle quickly flip 180 °, the bevel down slowly into the needle, reaching the desired depth, the needle flip 180 °, the angle of the fixed puncture needle during puncture or the angle close to puncture. Comparing the incidence of complications of two groups of fistula and the degree of pain in patients. Results: The incidence of arteriovenous fistula hemangioma, stenosis and occlusion in group B was lower than that in group A, and the pain in group B was lower than that in group A, and the differences between the two groups were statistically significant. Conclusion: The group B puncture for maintenance hemodialysis patients can effectively protect the arteriovenous fistula, reduce the occurrence of fistula complications, relieve the pain during puncture and improve the dialysis treatment effect.