自体动静脉内瘘使用早期的护理干预及观察.docVIP

精品论文 参考文献 自体动静脉内瘘使用早期的护理干预及观察 吴红梅 梅咏华 ( 湖北省孝感市中心医院肾内科 湖北孝感 432000) 　　【摘要】目的 为巩固血液透析患者自体动静脉内瘘手术疗效、保证长期安全使用，探讨使用早期科学合理的护理干预措施。方法 对83例自体动静脉内瘘使用早期，实施护理干预：①穿刺前进行内瘘血管评估；②开始使用时由有经验的护士选择内瘘肘部头静脉或贵要静脉作为引血通路进行穿刺；③提高护士技能，养成良好工作习惯，预防并发症及早期处置④给予患者健康指导，提高自我护理技能。结果 本中心83例AVF患者无感染发生，1例糖尿病肾病顽固性低血压患者规律透析25月后出现血管狭窄至闭塞，目前内瘘使用已达36月10例、24-36月24例、12-24月32例、不足12月16例，透析血流量均达到210至300ml/min，功能良好。结论 对血液透析患者自体动静脉内瘘实施早期护理干预，能促进内瘘成熟,提高造瘘成率，对防治并发症,延长内瘘使用寿命起重要作用。 　　【关键词】自体动静脉内瘘 早期 护理干预 健康指导 　　【中图分类号】R473.5 【文献标识码】A 【文章编号】1672-5085（2014）03-0053-03 　　 　　Autogenous arteriovenous fistula in the early nursing intervention and observation 　　WU Hongmei，MEI Yonghua 　　 (Department of Nephrology,Xiaogan Central Hospital，Xiaogan 432000,China) 　　【Abstract】 Objective to consolidate hemodialysis patients with autogenous arteriovenous internal fistula surgical curative effect, ensure the safety of long-term use, discusses the nursing intervention measures of early use of scientific and reasonable.Methods With the nursing intervention to 83 cases of early autogenous arteriovenous fistula in use:①estimate the fistula blood vessels before the assessment; ② Began to use by an experienced nurse with 17 g needle puncture, choose the internal fistula elbow cephalic vein or expensive to venous blood as a guide path; ③ improve Nursing skills, develop good working habits; ④ give patients health guidance, avoid and reduce the complications occurred in fistula. Results In our center, 83 AVF patients without infection, 1 case of diabetic nephropathy patients with refractory hypotension , hemal stricture and occlusion after 25 months regular dialysis, 10 cases of internal fistula is used currently has 36 months, 24 to 36 months 24 cases, 12 to 24 months December 16 cases, 32 cases, inadequate dialysis, blood flow are for 210 to 300 ml/min, function is good. Conclusions early nursing intervention to autogenous arteriovenous fistula in hemodialysis patients can