喜疗妥联合远红外线治疗血液透析内瘘患者的效果及护理

摘要

Objective To explore the effect of hiru doid combined far infrared ray on hemodialysis flow for hemodialysis fistula patients at first used .Methods Chosen 75 hemodialysis fistula patients and divied two groups.Traditional group (n=35) accepted the traditional hirudoid method after fistula operation , improved group (n=40) received hirudoid combined far infrared ray;research would compare the results of nursing care between two groups.Results The research showed the effective rate of nursing care was 95.00% in improved group,and was 48.57%in traditional group, the differences had statistical significance (χ2 =6.08,P<0.05);the vasal inner diameter and vasal thickness of improved group were (5.56 ±0.37)mm and (0.63 ±0.07)mm, and were (5.01 ±0.21),(0.54 ±0.04)mm of traditional group, the differences had statistical significance (t=2.65,2.71, respectively;P<0.05);hemodialysis flow 4 weeks after operation of improve group was (239.04 ± 35.43) ml , first used patients was(210.31 ±35.42)ml, the differences had statistical significance (t =3.85, P <0.05 ).Moreover, the improved group also contributed to the blood flow volume , angiostegnosis, hematoma.The rate of blood flow volume shortage , angiostegnosis, hematoma were 0.00%,5.00%,2.50%, comparing with 28.57%,20.00%,20.00%in traditional group, the differences had statistical significance (χ2 =4.03,3.96,3.99, respectively;P<0.05).However, the rate of thrombosis were 0.00% (improved group) and 8.57%( traditional group ) (χ2 =2.01, P >0.05 ).Conclusions Improved group advanced the hemodialysis flow by promoting fistula becoming mature , vasoactivity and fistula fibrillation , and reduced clinical complications and enhanced patients'the quality of life .%目的：探讨喜疗妥外涂联合远红外线照护对血液透析患者内瘘护理后初次使用率及透析血流量的影响。方法选取75例血液透析自体动静脉内瘘护理患者，内瘘术后采用传统法局部喜疗妥外涂护理的35例患者为传统组，而采用改良法喜疗妥外涂联合远红外线照护的40例患者为改良组，比较两种不同内瘘护理效果。结果改良组护理有效率为95．00％，高于传统组的48．57％，差异有统计学意义（χ2＝6．08，P＜0．05）；改良组血管内径、壁厚分别为（5．56±0．37），（0．63±0．07）mm，优于传统组（5．01±0．21），（0．54±0．04）mm，差异有统计学意义（t值分别为2．65，2．71；P＜0．05）；改良组术后4周透析血流量（239．04±35．43）ml大于初次透析血流量（210．31±35．42）ml，差异有统计学意义（t＝3．85， P＜0．05）；改良组血流量不足、血管狭窄、血肿发生率分别为0．00％，5．00％，2．50％，低于传统组的28.57％，20．00％，20．00％，差异有统计学意义（χ2值分别为4．03，3．96，3．99；P＜0．05），血管栓塞发生率改良组为0．00％，传统组为8．57％，组间比较差异无统计学意义（χ2＝2．01，P＞0．05）。结论改良法内瘘护理通过促进内瘘成熟，改善内瘘纤维化及血管弹性等途径达到理想的透析血流量，可延长使用时间及减少并发症，提高患者生活质量，值得临床推广使用。