血液净化用动静脉穿刺套管针的临床研究

摘要

Objective:To probe into the clinical application effect of arteriovenous puncture trocar used in blood purification.Methods:A total of 30 hemodialysis patients treated with mature fistula were selected,and each pa-tient received hemodialysis with ordinary internal fistula puncture needle (needle group)and internal fistula puncture trocar (soft needle group),10 times in each,then to observe and record the patients’pain and the limb activity when they were punctured by two kinds of puncture needles,their overall comfort during the treatment, the average value of arterial pressure and venous pressure before the pump,hemostatic time after withdrawal of needles,wound recovery,satisfaction to nurse puncture and the occurrence of puncture related adverse events in both groups.Results:The patients’punctured limb activity,overall comfort during the treatment,average value of arterial pressure and venous pressure before the pump,hemostatic time after withdrawal of needles,wound recovery and the occurrence of puncture related adverse events in soft needle group were all better than that in needle group,and the difference was statistically significant (P <0.05 );there was not statistically significant difference in puncture pain between both groups (P > 0.05 );the difficulty and total satisfaction of nurses in puncture in soft needle group were lower than that in needle group,but the satisfaction to decrease the potential danger of pricking wound in soft needle group was higher than that in needle group (P <0.05).Conclusion:He-modialysis arteriovenous trocar can increase the overall comfort of hemodialysis patients during the treatment and the activity of the punctured limb,decrease the incidence of puncture related adverse events and shorten the hemostatic time after withdrawal of needles.It is helpful for puncture wound recovery,and low pressure can en-sure adequate flow and dialysis effect in hemodialysis.We should pay attention to the related knowledge and op-eration skills training for nurses during clinical application.%[目的]探讨血液净化用动静脉穿刺套管针的临床应用效果。[方法]选择应用成熟内瘘进行血液透析治疗的病人30例，每例病人用普通内瘘穿刺针(钢针组)和内瘘穿刺套管针(软针组)各透析10次，观察并记录两组病人使用两种穿刺针穿刺时痛感、肢体的活动度，治疗过程中整体舒适度、泵前动脉压及静脉压的平均值、拔针后止血时间、伤口恢复情况，护士穿刺时的满意度及穿刺相关不良事件发生情况。[结果]软针组病人穿刺肢体的活动度、治疗过程中整体舒适度、泵前动脉压及静脉压、拔针后止血时间、伤口恢复情况、穿刺相关不良事件发生率均优于钢针组，差异有统计学意义(P <0.05)；穿刺时痛感两组差异无统计学意义(P >0.05)；软针组护士穿刺时的难度和总体满意度低于钢针组，但在降低潜在针刺伤危险方面的满意度高于钢针组(P <0.05)。[结论]血液净化用动静脉穿刺套管针可以增加血液透析病人的整体舒适度、穿刺肢体的活动度，降低穿刺相关不良事件发生率、缩短拔针后止血时间、利于穿刺伤口的恢复，透析过程中压力较低能保证充足的血流量，保证透析效果，在临床使用过程中要注重对护士相关知识及操作技能的培训。