Citation: | LI Chunhua, YANG Jiahui, ZHU Yamei, MA Xun, ZHANG Jing, WANG Ronghua, XU Wei. Effect of modified airtight blood return method on risk of thrombosis of arteriovenous fistula in patients with maintenance hemodialysis[J]. Journal of Clinical Medicine in Practice, 2023, 27(15): 73-76. DOI: 10.7619/jcmp.20231221 |
To explore the role of modified airtight blood return method in reducing the risk of thrombosis of arteriovenous fistula in patients with maintenance hemodialysis.
A total of 50 patients with regular hemodialysis from November 2021 to October 2022 were selected as research objects. From November 2021 to April 2022, the patients with traditional airtight bidirectional blood return method were included in control group, while the patients with modified airtight blood return method from May 2022 to October 2022 were included in modified group. The blood pressure after removing the dialyzer, compression time at the arteriovenous fistula puncture site after removing the dialyzer, fistula leakage rate, incidence of thrombus, residual red blood cells in the dialyzer, total time for blood return and physiological saline volume used for blood return were compared between the two methods.
In the modified group, blood return volume after removing the dialyzer, blood return time after removing the dialyzer, blood pressure after removing the dialyzer, compression time at the arteriovenous fistula puncture site after removing the dialyzer, fistula leakage rate, physiological saline volume used for blood return after removing the dialyzer, incidence of internal fistula thrombosis, and residual red blood cells in the dialyzer tube were significantly lower or shorter than those in the control group (P < 0.05).
Modified airtight blood return method can shorten the blood return time after removing the dialyzer, decrease the consumption of 0.9% sodium chloride solution, reduce the fistula leakage rate, shorten the compression time at the arteriovenous fistula puncture site after removing the dialyzer, reduce residual red blood cells in the dialyzer tube after removing the dialyzer, and fully reduce the blood viscosity in the local area of the internal fistula under the condition of blood return with equivalent physiological saline.
[1] |
SHIU Y T, ROTMANS J I, GEELHOED W J, et al. Arteriovenous conduits for hemodialysis: how to better modulate the pathophysiological vascular response to optimize vascular access durability[J]. Am J Physiol Renal Physiol, 2019, 316(5): F794-F806. doi: 10.1152/ajprenal.00440.2018
|
[2] |
金其庄, 王玉柱, 叶朝阳, 等. 中国血液透析用血管通路专家共识(第2版)[J]. 中国血液净化, 2019, 18(6): 365-381. https://www.cnki.com.cn/Article/CJFDTOTAL-ZGJH201906001.htm
|
[3] |
袁静, 李恒, 应金萍, 等. 102例血液透析患者动静脉内瘘血栓形成的原因及护理[J]. 中华护理杂志, 2020, 55(4): 607-610. https://www.cnki.com.cn/Article/CJFDTOTAL-ZHHL202004030.htm
|
[4] |
杨柳芬, 邓佳, 刘海梅, 等. 血液透析治疗回血方法研究进展[J]. 护理研究, 2022, 36(9): 1620-1622. https://www.cnki.com.cn/Article/CJFDTOTAL-SXHZ202209022.htm
|
[5] |
冼建珍, 林月群, 廖彬容, 等. 维持性血液透析患者动静脉内瘘栓塞形成影响因素分析[J]. 护理实践与研究, 2021, 18(17): 2557-2560. https://www.cnki.com.cn/Article/CJFDTOTAL-HLSJ202117007.htm
|
[6] |
叶丽钦, 张海林, 周莹. 血液透析患者衰弱的相关研究进展[J]. 中华护理杂志, 2018, 53(1): 99-104. https://www.cnki.com.cn/Article/CJFDTOTAL-ZHHL201801027.htm
|
[7] |
张兰珍, 徐武敏, 谷禾. 三通回血法在中心静脉置管维持性血液透析患者中的应用[J]. 中华现代护理杂志, 2015, 21(14): 1723-1725, 1726.
|
[8] |
谢巧明. 尿毒症血液透析患者自体动静脉内瘘成熟的影响因素[J]. 护理实践与研究, 2022, 19(5): 655-658. https://www.cnki.com.cn/Article/CJFDTOTAL-HLSJ202205006.htm
|
[9] |
周诗雯, 何清时, 柴冬雪, 等. 在线密闭式双向回血法在血液透析滤过治疗结束时的应用[J]. 中国血液净化, 2022, 21(6): 453-455. https://www.cnki.com.cn/Article/CJFDTOTAL-ZGJH202206016.htm
|
[10] |
徐玮, 张静, 朱亚梅, 等. 内瘘使用初期不同拔针时间对血液透析内瘘早期并发症影响的研究[J]. 中国血液净化, 2015, 14(11): 692-695. https://www.cnki.com.cn/Article/CJFDTOTAL-ZGJH201511015.htm
|
[11] |
郑海燕, 王潘. 对血液净化标准操作规程中推荐密闭式回血的认识和解读[J]. 医药前沿, 2017, 7(20): 390-391.
|
[12] |
李燕, 卢秋芳, 罗珍, 等. 血液透析病人自体动静脉内瘘晚期失功的影响因素及对策[J]. 循证护理, 2022, 8(17): 2365-2369. https://www.cnki.com.cn/Article/CJFDTOTAL-XZHL202217021.htm
|
[13] |
ZHANG Y H, YI J, ZHANG R Z, et al. Risk factors for arteriovenous fistula Thrombus development: a systematic review and meta-analysis[J]. Kidney Blood Press Res, 2022, 47(11): 643-653.
|
[14] |
张美兰, 毛鑫. 维持性血液透析患者动静脉内瘘血栓形成的相关护理及处置[J]. 血栓与止血学, 2017, 23(5): 867-869. https://www.cnki.com.cn/Article/CJFDTOTAL-XSZX201705050.htm
|
[15] |
李敏, 张帆, 董艳, 等. 高危自体动静脉内瘘的管理实践研究[J]. 当代护士: 中旬刊, 2022(2): 65-67. https://www.cnki.com.cn/Article/CJFDTOTAL-DDHS202202021.htm
|
[16] |
骆俊秀, 汪吉平, 李虹, 等. 密闭式回血法对降低动静脉内瘘并发症的临床观察[J]. 中国血液净化, 2012, 11(2): 107-109. https://www.cnki.com.cn/Article/CJFDTOTAL-ZGJH201202021.htm
|
[17] |
崔文英, 李莉. "双向"回血法在血液透析中的临床应用[J]. 中国血液净化, 2008, 7(2): 111-112. https://www.cnki.com.cn/Article/CJFDTOTAL-ZGJH200802019.htm
|
[18] |
张兆星. 维持性血液透析肾功能衰竭动静脉内瘘血栓形成原因[J]. 中国卫生标准管理, 2020, 11(7): 68-71. https://www.cnki.com.cn/Article/CJFDTOTAL-WSBZ202007026.htm
|
[19] |
申鹏, 李宏, 郭珏, 等. 血液透析患者自体动静脉内瘘血栓预防的最佳证据总结[J]. 中华护理杂志, 2022, 57(13): 1634-1640. https://www.cnki.com.cn/Article/CJFDTOTAL-ZHHL202213013.htm
|
[20] |
李泽争, 王葳, 陆石, 等. 维持性血液透析患者自体动静脉内瘘血管内膜增生的机制研究[J]. 中国血液净化, 2016, 15(6): 330-334. https://www.cnki.com.cn/Article/CJFDTOTAL-ZGJH201606005.htm
|
[21] |
张宇涵, 马岩, 彭宇, 等. 自体动静脉内瘘血栓危险因素的Meta分析[J]. 中国血液净化, 2021, 20(2): 126-129. https://www.cnki.com.cn/Article/CJFDTOTAL-ZGJH202102014.htm
|