自制动静脉内瘘保护套联合远红外照射在超高压球囊扩张术治疗维持性血液透析病人自体动静脉内瘘狭窄中的应用

目的观察自制动静脉内瘘保护套联合远红外照射在超高压球囊扩张术治疗维持性血液透析病人自体动静脉内瘘（内瘘）狭窄中的应用效果。方法选取52例维持性血液透析内瘘狭窄行超高压球囊扩张术病人作为研究对象，采用随机数字表法分为对照组和观察组。对照组给予握拳与放松、内瘘局部热敷等常规护理；观察组在此基础上给予动静脉内瘘保护套保护术侧肢体，同时予以远红外线治疗仪照射护理。比较2组病人术后6个月内瘘自然流量、并发症发生情况、内瘘再狭窄的发生率及对护理的满意度情况。结果52例病人术后1~3 d均能首次使用内瘘进行血液透析治疗，6个月后观察组内瘘自然流量及护理满意度明显高于对照组（P < 0.01），并发症发生率明显低于对照组（P < 0.05），内瘘再狭窄发生率与对照组差异无统计学意义（P>0.05）。结论超高压球囊扩张术可有效解除内瘘狭窄，自制动静脉内瘘保护套联合远红外照射可显著改善维持性血液透析病人自体动静脉内瘘血流量，降低并发症的发生率。

Application value of the self-made protective sheath of arteriovenous fistula combined with far-infrared irradiation in maintenance hemodialysis patients treated with ultra-high pressure balloon dilatation

ObjectiveTo observe the application effects of the self-made protective sheath of arteriovenous fistula(AVF) combined with far-infrared irradiation in maintenance hemodialysis patients treated with ultra-high pressure balloon dilatation.MethodsFifty-two maintenance hemodialysis patients with autologous AVF stenosis treated with ultra-high pressure balloon dilatation were divided into the control group and observation group using random number table method.The control group was routinely nursed with fist clenching, relaxation combined with local hot compress of internal fistula, and the observation group was nursed with the protective sheath of arteriovenous fistula to protect the limbs of the operative side combined with far-infrared radiation at the same time.The natural flow rate of fistula, incidence rate of complications, incidence rate of restenosis of fistula and nursing satisfaction were compared between two groups within 6 months after surgery.ResultsFifty-two patients with fistula could firstly be treated with for hemodialysis after 1-3 days of operation.After 6 months of treatment, the natural flow volume of fistula and nursing satisfaction in observation group were significantly higher than those in control group(P < 0.01), the incidence rate of complications in observation group was significantly lower than that in control group(P < 0.05), and the differences of the incidence rate of restenosis between two groups was not statistically significant(P>0.05).ConclusionThe ultra-high pressure balloon dilatation can effectively relieve the AVF stenosis.The self-made protective sheath of arteriovenous fistula combined with far-infrared radiation can significantly improve the blood flow of arteriovenous fistula, and reduce the incidence rate of complications in maintenance hemodialysis patients.