[摘要]目的 研究繩梯法與區(qū)域法穿刺方法在自體動(dòng)靜脈內(nèi)瘺功能狀態(tài)中的應(yīng)用價(jià)值。方法 選擇我院2015年6月～2017年4月納入的96例血液透析并新建內(nèi)瘺手術(shù)患者作為研究對(duì)象，按照隨機(jī)數(shù)字法分為研究組和對(duì)照組，各48例。研究組患者采取繩梯法，對(duì)照組患者采取區(qū)域法，比較兩種穿刺方法效果。結(jié)果 經(jīng)觀察兩組穿刺效果，兩組穿刺成功率、血流量不足以及皮下血腫發(fā)生率均無明顯差別（χ2=0.721，0.438，2.178，P>0.05），但研究組滲血發(fā)生率較對(duì)照組低（χ2=5.350，P<0.05）；研究組并發(fā)癥發(fā)生率（4.17%）明顯較對(duì)照組（16.67%）降低（χ2=8.370，P<0.05）；滿意度為97.92%，高于對(duì)照組的83.33%，差異有統(tǒng)計(jì)學(xué)意義（χ2=12.527，P<0.05）。結(jié)論 血液透析并新建內(nèi)瘺術(shù)患者采取繩梯法與區(qū)域法穿刺均具有一定應(yīng)用價(jià)值，但繩梯法穿刺后并發(fā)癥較少，安全性高，能夠維持良好醫(yī)患關(guān)系。
　　[關(guān)鍵詞]動(dòng)靜脈內(nèi)瘺；區(qū)域法；血液透析；繩梯法
　　[中圖分類號(hào)] R472.9 [文獻(xiàn)標(biāo)識(shí)碼] A [文章編號(hào)] 1674-4721（2018）2（b）-0188-03
　　Comparison of rope ladder and area puncture on the influence of the functional status of autologous arteriovenous fistula
　　ZHANG Qiao-rong LIU Li ZHANG Jin-lian
　　Hemodialysis Center，People′s Hospital of Jiexi County，Guangdong Province，Jiexi 515400，China
　　[Abstract]Objective To study the application value of rope ladder and area puncture on the influence of the functional status of autologous arteriovenous fistula.Methods From June 2015 to April 2017，96 hemodialysis patients with new internal fistula surgery were selected as research objects in our hospital.By a random number table method，they were evenly divided into research group and control group，48 cases in each group.In the research group，rope ladder was used，while in the control group，area puncture was adopted.The puncture effect of the two methods was compared.Results By observing the puncture effect，the success rate of puncture and incidence of insufficiency of blood flow volume and subcutaneous hematoma were not displayed great differences （χ2=0.721，0.438，2.178，P>0.05），but the errhysis incidence was lower in the research group （χ2=5.350，P<0.05）.In the research group，the incidence of complications was 4.17%，significantly lower than that in the control group accounting for 16.67%（χ2=8.370，P<0.05）.The satisfaction in the research group was 97.92%，higher than that of the control group，83.33%，with a statistical difference （χ2=12.527，P<0.05）.Conclusion For hemodialysis patients with new fistula surgery，both rope ladder and area puncture have certain application value，but few complications，high safety，and a good doctor-patient relationship maintained after rope ladder puncturing.
　　[Key words]Arteriovenous fistula；Area puncture；Hemodialysis；Rope ladder
　　維持性血液透析屬于急慢性腎衰竭患者腎臟代替的主要治療方式，是指將患者機(jī)體內(nèi)血液引流至體外，并利用無數(shù)根空心纖維構(gòu)成的透析儀器，使血液與透析液通過彌散及對(duì)流方式發(fā)生物質(zhì)交換，能夠有效清除體內(nèi)代謝廢物，保持電解質(zhì)以及酸堿平衡，同時(shí)清除多余水分，最后將凈化血液回輸[1]。建立動(dòng)靜脈內(nèi)瘺屬于臨床上常見的血管通路方式，其通路功能可直接影響患者治療效果，采取有效內(nèi)瘺穿刺方法可保證其完整性，延長(zhǎng)使用期限[2-3]。其中區(qū)域穿刺被廣泛應(yīng)用于臨床，雖然取得過一定應(yīng)用價(jià)值，但安全性較低，易出現(xiàn)血栓、血管瘤以及內(nèi)瘺閉塞等癥狀，嚴(yán)重威脅患者身心健康，受到醫(yī)療界廣泛關(guān)注。由于臨床上穿刺方法較多，如何選擇療效確切且安全性較高的方式在保障患者生命安全中具有重要意義[4]。本文選擇納入的血液透析并新建內(nèi)瘺手術(shù)患者作為研究對(duì)象，探討繩梯法與區(qū)域法穿刺方法在自體動(dòng)靜脈內(nèi)瘺患者治療中的應(yīng)用價(jià)值，現(xiàn)報(bào)道如下。

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