目的：探讨血液透析自体动静脉内瘘拟行扣眼法穿刺时，用血液透析留置针建立扣眼的可行性。方法对2012年3月至2013年3月在该院拟行扣眼法穿刺的患者40例随机分成2组，对照组和观察组各20例。对照组采取传统方法。观察组操作者用血透留置针穿刺并留置内瘘至更换钝针穿刺为止。比较两组建立扣眼的效果差异及不良反应，对数据进行统计学处理。结果两组建立扣眼成功率分别为对照组95．0％，观察组97．5％，无统计学差异（P＞0．05）；两组建立一对扣眼平均耗时、扣眼钝针穿刺容易例次、钝针初始穿刺一月疼痛评分，差异均有统计学意义（P＜0．01）。观察组留置针打折3例、凝血1例、留置针留置内瘘侧肢体轻度胀痛3例，对照组穿刺渗血48次。结论留置针建立扣眼的效率高于普通内瘘穿刺针，能缓减扣眼穿刺护士人力资源配置不足的压力，有利于扣眼穿刺的持续开展，但对患者透析间期依从性有较高的要求。%Objective To investigate the feasibility of establishing buttonholes on patients using hematodialysis remaining needles when puncturing autogeneic internal arteriovenous fistula .Methods Forty cases were randomized to the treatment group with establishing buttonholes and control group with traditional methods ,20 cases in each group .There were some indices recorded and compared in 2 groups including the cases of establishing buttonholes ,time consumption,puncture times,blunt needle’s difficulty degree,pain scores and the adverse reaction .Results There were no obvious differences in the achievement ratio of establishing buttonholes between these two groups(P>0.05).However,these indices in the treatment group were superior to those in the control group including the average time consumption,the average puncture times,the blunt needle puncture times,and the 1-month pain scores(P<0.01).In the treat-ment group ,3 cases were kinked ,1 case blood clotting ,3 cases mild limb pain ,while in the control group ,48 cases were bleeding at the puncture site.Conclusions The achievement ratio of establishing buttonholes is superior to the common internal fistula needle ,which can relieve lack in human resources ,benefit the continuing work of buttonhole puncture ,yet requires higher patients ’ compliance .
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