Objective To explore the nursing skill of mature fistula used to prolong the service life of inside fistula. Methods A total of 850 patients, undergoing maintenance hemodialysis and using internal arteriovenous fistula for the first time, were enrolled as research subjects. Patients were first given psychological nursing, puncture time and appropriate needles chosen scientifically, blood flow set up reasonably and correct methods used to perform hemostasis by compression. Achievement ratio of first puncture and complications were observed. Results A total of 789 patients succeeded in first puncture ( 92. 8% ), internal fistula used successfully for 1 ~ 10 years; 61 failed, thereinto 47 put off using internal fistula for 1 ~2 weeks; 10 used femoral vein cardiac catheter at arterial end and internal fistula after hemodialysis on upper limb of fistula side at vein end for 1 week; 3 had phlebothrombosis and given embolectomy; 1 had penetrating wound at arterial end, hematoma formed, incision and drainage performed and fistula remade after recovery. Conclusion Psychological nursing, appropriate time and needles, reasonable blood flow and correct hemostasis by compression can improve achievement rate of first puncture, reduce incidence of complications, prolong the service time of internal fistula and improve patients' quality of life.%目的 探讨内瘘成熟后首次使用时的护理技巧,以延长内瘘的使用寿命.方法 以2002年1月-2012年1月在我院行维持性血液透析且动静脉内瘘成熟后首次使用的850例患者作为研究对象,穿刺者在首次使用动静脉内瘘时,先对患者进行心理护理,并选择科学的穿刺时间、适宜的穿刺针,设置合理的血流量,透析结束后采用正确的方式压迫止血,观察首次穿刺成功率及穿刺并发症.结果 850例患者中789例患者首次穿刺成功,成功率为92.8%,内瘘使用1~10年.61例首次穿刺失败,其中47例延期1~2周使用内瘘;10例动脉端使用股静脉中心导管,静脉端使用内瘘侧上肢静脉透析1周后使用内瘘;3例在静脉端血肿形成静脉血栓,行取栓术;1例动脉端穿透伤,造成血肿,切开引流,恢复后重新造瘘.结论 内瘘首次使用时,穿刺者通过对患者进行心理护理、选择合适的穿刺时间和穿刺针、设置合理的血流量、透析结束后正确地压迫止血等技巧,可提高首次穿刺成功率,有效减少内瘘并发症的发生,延长内瘘的使用寿命,提高血液透析患者的生命质量.
展开▼
