血液透析病人动静脉内瘘扣眼穿刺并发症的原因分析及护理对策

目的]探讨自体动静脉内瘘运用钝针扣眼穿刺法后并发症的原因及护理对策。方法]回顾性分析83例维持性血液透析病人动静脉内瘘扣眼穿刺法后发生并发症的原因及护理对策。结果]83例病人进行动静脉内瘘扣眼穿刺总数76次~468次,期间发生内瘘并发症50例,包括穿刺点及隧道感染15例,穿刺点渗血6例,隧道狭窄或闭合22例,穿刺点湿疹7例,分析原因主要与护士操作技术、使用器材、病人自身原因或知识缺乏等有关。结论]虽然扣眼穿刺法提高了穿刺成功率,但也会发生一些并发症,经过原因分析及有效的护理措施,可以降低动静脉内瘘扣眼穿刺并发症的发生率。

Reasons and nursing countermeasures of complications of arteriovenous fistula buttonhole puncture in hemodialysis patients

Objective:To probe into the reasons and nursing countermeasures of complications of arteriovenous fistula buttonhole puncture.Methods:A retrospective analysis was carried out for 83 cases of maintenance he-modialysis patients on the reason and nursing countermeasures of the complications of arteriovenous fistula but-tonhole puncture in hemodialysis patients.Results:The total number of arteriovenous fistula buttonhole punc-ture in 83 patients was 76 468.The fistula complications occurred in 50 cases,including 15 cases with the puncture point and tunnel infection (18.07%),6 cases with puncture point bleeding in (7.22%),22 cases with tunnel stenosis or closed (26.50%),7 cases with puncture point eczema (8.43%).The main reasons were relat-ed to the operation of nursing skills,the use of equipment,the patients’own reasons or lack of knowledge and so on.Conclusion:Although buttonhole puncture could improve the success rate of puncture,but it also might cause some complications.The analysis of the causes and effective nursing measures could reduce the incidence of complications of arteriovenous fistula buttonhole puncture.