两种保护动静脉内瘘血管的护理体会(1)
【摘要】 目的：比较三七叶泥+多磺酸粘多糖联合应用与单纯使用多磺酸粘多糖湿敷内瘘血管，观察两种方法对患者内瘘血管弹性的保护与血肿吸收效果的比较。方法：总结本院2011年1月-2013年1月72例使用动-静脉内瘘行血液透析的患者，按照随机数字表法分成观察组36例与对照组36例，观察组产生内瘘血肿27例次，对照组产生血肿33例次，观察组采用三七叶泥联合多磺酸粘多糖交替对动-静脉内瘘血管和血肿进行湿敷，对照组使用多磺酸粘多糖湿敷动静脉内瘘血管和血肿。结果：观察组较对照组内瘘血管弹性好，血肿吸收快。结论：采用三七叶泥+多磺酸粘多糖联合应用在血透患者动静脉内瘘中的应用，能延缓内瘘血管的硬化，促进血肿的吸收，有效保护内瘘血管。
【关键词】 血液净化； 动静脉内瘘； 多磺酸粘多糖； 三七总皂苷
Comparison of Two Kinds of Protective Nursing Care for Arteriovenous Fistula/LIU Hui， LI Wen-xiu.//Medical Innovation of China，2015，12(24)：080-082
, 百拇医药
【Abstract】 Objective： To observe the protective effects on arteriovenous fistula (AV) vascular elasticity and comparison of hematoma absorption benefits of two wet dressing methods for patients with AV fistula hematoma， using Panax Notoginseng Leaves Mud and Mucopolysaccharide Polysulfate vs. only Mucopolysaccharide Polysulfate Cream. Method： Seventy-two patients on maintenance hemodialysis through AV fistula in our hospital from January 2011 to January 2013 were selected and randomly assigned 36 cases to experimental group and 36 cases to control group. There were 27 episodes of AV fistula hematoma developed in the experimental group， and 33 episodes of AV fistula hematoma developed in the control group. The patients in the experimental group received wet dressing care over the AV fistula and hematoma with Panax Notoginseng Leaves Mud alternatively with Mucopolysaccharide Polysulfate Cream. The patients in the control group received wet dressing care over the AV fistula and hematoma with only Mucopolysaccharide Polysulfate Cream. Result： The AV fistula vascular elasticity was better preserved in the experimental group than control group and the hematomas were resolved significantly faster in the experimental group. Conclusion： Application of Panax Notoginseng leaves mud and Mucopolysaccharide Polysulfate Cream wet dress in the treatment of hemodialysis patients with AV fistula hematoma can delay AV fistula sclerosis， expedite hematoma absorption and effectively protect AV vasculature.
, 百拇医药
【Key words】 Hemodialysis； Arteriovenous fistula； Mucopolysaccharide polysulfate； Panax notoginseng saponins
First-author’s address： Ziyang People’s Hospital， Ziyang 641399， China
doi：10.3969/j.issn.1674-4985.2015.24.029
血液透析是治疗终末期肾病的常用方法之一，效果的好坏主要依赖于是否有一条理想的血管通路[1]。终末期肾功能衰竭患者血液透析的血管通路首选动-静脉内瘘，是血液透析患者赖以生存的生命线[2]。内瘘的长期使用寿命与手术吻合方式有关。动静脉内瘘是目前血液透析最安全的血管通路，其创伤小，对心功能影响小，使用时间长，感染率低[3]。精心护理好动静脉内瘘，延长其使用寿命，就是延长了血液透析患者的生命[4]。可见动静脉内瘘在血液透析中的重要性，如何保护好内瘘血管，是血液净化工作者不断探索的问题。在临床工作中发现，终末期肾病患者动静脉内瘘血管均有不同程度的硬化，血管弹性较差，脆性较大，有穿刺失败的风险及在穿刺与拔针时产生血肿，加大了对动静脉内瘘血管的损伤，严重影响动静脉内瘘血管的使用寿命。本科工作人员采用三七叶泥联合多磺酸粘多糖对血液透析患者动静脉内瘘及血肿交替湿敷，发现采用该种方法对内瘘血管进行保护，患者内瘘血管的弹性较好、血肿吸收较快，保护了内瘘血管，减轻了患者的痛苦。, 百拇医药(刘慧 李文秀)
【关键词】 血液净化； 动静脉内瘘； 多磺酸粘多糖； 三七总皂苷
Comparison of Two Kinds of Protective Nursing Care for Arteriovenous Fistula/LIU Hui， LI Wen-xiu.//Medical Innovation of China，2015，12(24)：080-082
, 百拇医药
【Abstract】 Objective： To observe the protective effects on arteriovenous fistula (AV) vascular elasticity and comparison of hematoma absorption benefits of two wet dressing methods for patients with AV fistula hematoma， using Panax Notoginseng Leaves Mud and Mucopolysaccharide Polysulfate vs. only Mucopolysaccharide Polysulfate Cream. Method： Seventy-two patients on maintenance hemodialysis through AV fistula in our hospital from January 2011 to January 2013 were selected and randomly assigned 36 cases to experimental group and 36 cases to control group. There were 27 episodes of AV fistula hematoma developed in the experimental group， and 33 episodes of AV fistula hematoma developed in the control group. The patients in the experimental group received wet dressing care over the AV fistula and hematoma with Panax Notoginseng Leaves Mud alternatively with Mucopolysaccharide Polysulfate Cream. The patients in the control group received wet dressing care over the AV fistula and hematoma with only Mucopolysaccharide Polysulfate Cream. Result： The AV fistula vascular elasticity was better preserved in the experimental group than control group and the hematomas were resolved significantly faster in the experimental group. Conclusion： Application of Panax Notoginseng leaves mud and Mucopolysaccharide Polysulfate Cream wet dress in the treatment of hemodialysis patients with AV fistula hematoma can delay AV fistula sclerosis， expedite hematoma absorption and effectively protect AV vasculature.
, 百拇医药
【Key words】 Hemodialysis； Arteriovenous fistula； Mucopolysaccharide polysulfate； Panax notoginseng saponins
First-author’s address： Ziyang People’s Hospital， Ziyang 641399， China
doi：10.3969/j.issn.1674-4985.2015.24.029
血液透析是治疗终末期肾病的常用方法之一，效果的好坏主要依赖于是否有一条理想的血管通路[1]。终末期肾功能衰竭患者血液透析的血管通路首选动-静脉内瘘，是血液透析患者赖以生存的生命线[2]。内瘘的长期使用寿命与手术吻合方式有关。动静脉内瘘是目前血液透析最安全的血管通路，其创伤小，对心功能影响小，使用时间长，感染率低[3]。精心护理好动静脉内瘘，延长其使用寿命，就是延长了血液透析患者的生命[4]。可见动静脉内瘘在血液透析中的重要性，如何保护好内瘘血管，是血液净化工作者不断探索的问题。在临床工作中发现，终末期肾病患者动静脉内瘘血管均有不同程度的硬化，血管弹性较差，脆性较大，有穿刺失败的风险及在穿刺与拔针时产生血肿，加大了对动静脉内瘘血管的损伤，严重影响动静脉内瘘血管的使用寿命。本科工作人员采用三七叶泥联合多磺酸粘多糖对血液透析患者动静脉内瘘及血肿交替湿敷，发现采用该种方法对内瘘血管进行保护，患者内瘘血管的弹性较好、血肿吸收较快，保护了内瘘血管，减轻了患者的痛苦。, 百拇医药(刘慧 李文秀)