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目的探讨研究糖尿病肾病维持性血液透析患者动静脉内瘘的临床护理效果。方法选取于2014年6月至2016年6月期间来我院救治的100例糖尿病肾病维持性血透析患者为此次研究对象,随机将其分为观察组及参照组,各50例。参照组患者采取常规护理,主要包括术前护理、穿刺护理及术后护理等。观察组患者在此基础上加以饮食护理、锻炼指导、心理护理及强化动静脉内瘘护理。对两组患者内瘘成熟时间及内瘘阻塞、狭窄、血栓、感染等并发症的情况进行观察比较。结果观察组患者内瘘成熟时间为(6.4±0.5)周,明显短于参照组的(7.8±0.8)周,差异显著(P<0.05),有统计学意义。观察组中有3例患者出现并发症,并发症发生率为6.0%;参照组中发生并发症的有10例,并发症发生率为20.0%,观察组患者的并发症发病率明显低于参照组(P<0.05),差异有统计学意义。结论护理人员在临床中应在对患者给予常规护理的同时,加强对其的心理护理、饮食护理、内瘘护理等,并熟练掌握穿刺技术,在术后应尽可能早的恢复功能锻炼,促进动静脉内瘘尽快成熟,指导患者及其家属正确保护动静脉内瘘,降低并发症发生的可能,提升患者的治疗效果及其生活质量。
Objective To investigate the clinical nursing effect of arteriovenous fistula in maintenance hemodialysis patients with diabetic nephropathy. Methods One hundred patients with diabetic nephropathy who had been treated in our hospital from June 2014 to June 2016 were selected as the study subjects and randomly divided into observation group and reference group with 50 cases in each group. The reference group of patients to take routine care, including preoperative care, puncture nursing and postoperative care. On the basis of this, patients in the observation group were given diet care, exercise instruction, psychological nursing and intensive arteriovenous fistula care. Fistula maturation time and fistula occlusion, stenosis, thrombosis, infection and other complications were observed and compared between the two groups. Results The fistula maturation time was (6.4 ± 0.5) weeks in observation group, which was significantly shorter than that in the reference group (7.8 ± 0.8) weeks, with significant difference (P <0.05). In the observation group, 3 patients had complications and the complication rate was 6.0%. In the reference group, 10 patients had complications and the complication rate was 20.0%. The incidence of complication in the observation group was significantly lower than that of the reference group Group (P <0.05), the difference was statistically significant. Conclusion Nursing staff should be in the clinical routine care should be given to patients at the same time, strengthen their psychological care, diet nursing, fistula care, etc., and master the puncture technique, postoperative functional rehabilitation should be as early as possible to promote Arteriovenous fistula matures as soon as possible to guide patients and their families to properly protect the arteriovenous fistula, reduce the possibility of complications, improve the patient’s treatment and quality of life.