护理指导与家庭支持护理在慢性肾脏病维持性血液透析患者动静脉内瘘通畅率改善中的应用效果

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摘要目的探讨护理指导与家庭支持护理在慢性肾脏病维持性血液透析患者动静脉内瘘（AVF）通畅率改善中的应用效果。方法选取2019年1月至2021年3月于潍坊市益都中心医院血液透析中心初次建立AVF 并初次进入透析的慢性肾脏病患者60 名作为研究对象，按照随机数字表法分为A 组（n=30）和B 组（n=30）。A 组通过常规院内护理指导加家庭支持护理的方式进行AVF 维护，B 组采用常规院内护理指导的方式进行内瘘的维护，两组均干预12 周，统计两组患者AVF 狭窄、AVF 血栓形成、AVF 感染、肿胀手综合征、窃血综合征和AVF 闭塞等并发症情况，并应用Kaplan-Meier 法和Log-Rank 生存率检验分析比较分析两组患者的AVF 通畅率。结果干预12 周末A 组的AVF 通畅率高于B 组，差异有统计学意义（P＜0.05）。A 组AVF 相关并发症的总发生率和失功率低于B 组，差异有统计学意义（P＜0.05）。结论护理指导与家庭支持护理相结合在改善慢性肾脏病维持性血液透析患者AVF 通畅率方面具有重要意义，值得在临床推广应用。

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	张桂凤
	蔡淑芳
	王从政
	常玲玲
	王小翠

关键词 ：慢性肾脏病, 血液透析, 自体动静脉内瘘, 家庭支持护理

Abstract：Objective To investigate the efficacy of nursing guidance and home supportive care in improving patency of autogenous arteriovenous fistulas(AVF)in chronic kidney disease(CKD)patients on maintenance hemodialysis.Methods Sixty CKD patients with AVF initially established at the hemodialysis center of Shandong Weifang Yidu Central Hospital between January 2019 and March 2021 and initially entered dialysis were selected as research objects.The random number table method was applied to divide the enrolled patients into two groups on average.Autogenous AVF maintenance was performed in the home support nursing group(group A, n=30)by routine in-hospital nursing guidance plus home support nursing,and in the control group(group B, n=30)by routine in-hospital nursing guidance.The complications,such as AVF stenosis,AVF thrombosis,AVF infection,swelling hand syndrome,plagiarism syndrome,and AVF occlusion,were counted after 12 weeks of intervention in each of the two groups.The chi-square test was used to compare the difference in complication rates between the two groups,and the patency rates of the AVF in the two groups were compared and analyzed by the Kaplan Meier method.Results The patency rate of AVF at the end of 12 weeks of intervention in group A was higher than that in group B,with significant difference(P＜0.05).The total incidence of AVF related complications and failure rate in group A was lower than that in group B,with significant difference(P＜0.05).Conclusion The combination of nursing guidance and home supportive care is of great importance in improving the patency of autogenous AVF in CKD patients on maintenance hemodialysis,and is worth promoting in the clinic.

Key words： Chronic kidney disease Hemodialysis Autogenous arteriovenous fistulas Home supportive care

基金资助:山东省潍坊市卫生健康委员会科研项目（WFWS JK-2021-238

引用本文:

张桂凤;蔡淑芳; 王从政;常玲玲;王小翠. 护理指导与家庭支持护理在慢性肾脏病维持性血液透析患者动静脉内瘘通畅率改善中的应用效果[J]. 中国当代医药, 2022, 29(10): 170-173.
ZHANG Guifeng;CAI Shufang; WANG Congzheng; CHANG Lingling;WANG Xiaocui. Efficacy of nursing guidance and home supportive care in improving patency of autogenous arteriovenous fistulas in chronic kidney disease patients on maintenance hemodialysis. 中国当代医药, 2022, 29(10): 170-173.

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