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1、自体动静脉内痿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痿手术疗效、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例自体动静脉内痿使用早期,实施护理干预:①穿刺前进行内痿血管评估;②开始使用时由有经验的护上选择内痿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。结果木中心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,目前内痿使用已达36月1
2、0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痿实施早期护理干预,能促进内痿成熟,提高造痿成率,对防治并发症,延长内痿使用寿命起重要作用。【关键词】自体动静脉内痿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)03-0053-03AutogenousarteriovenousfistulaintheearlynursinginterventionandobservationWUHongmei,MEIYonghua(De
3、partmentofNephrology,XiaoganCentralHospital,Xiaogan432000,China)[Abstract】Objectivetoconsolidatehemodialysispatientswithautogenousarteriovenousinternalfistulasurgicalcurativeeffect,ensurethesafetyoflong-termuse,discussesthenursinginterventionmeasuresofearlyuseofscientificandreasonable.Meth
4、odsWiththenursinginterventionto83casesofearlyautogenousarteriovenousfistulainuse:①estimatethefistulabloodvesselsbeforetheassessment;②Begantousebyanexperieneednursewith17gneedlepuncture,choosetheinternalfistulaelbowcephalicveinorexpensivetovenousbloodasaguidepath;(3)improveNursingskills,dev
5、elopgoodworkinghabits;④givepatientshealthguidanee,avoidandreducethecomplicationsoccurredinfistula.ResultsInourcenter,83AVFpatientswithoutinfection,1caseofdiabeticnephropathypatientswithrefractoryhypotension,hemalstrictureandocclusionafter25monthsregulardialysis,10casesofinternalfistulaisus
6、edcurrentlyhas36months,24to36months24cases,12to24monthsDecember16cases,32cases,inadequatedialysis,bloodflowarefor210to300ml/min,functionisgood.Conclusionsearlynursinginterventiontoautogenousarteriovenousfistulainhemodialysispatientscanpromoteinternalfistulamaturity,improvethesuccessrateoff
7、istula,andplayanimportantroleinthepreventionandtreatmentofcomplications,prolongingtheservicelifeofinternalfistula.【Keywords]Autogenousarteriovenousfistula;Early;Nursingintervention;Healthguidanee自体动静脉内痿(ArteriovenousFistula,AVF)是指通过手术的方法将动静脉在皮下吻合建立的血管通路,是尿毒症血液