Application of the buttonhole puncture management program for difficult autologous arteriovenous fistula in hemodialysis patients
Objective To establish a management program for difficult autologous arteriovenous fistula buttonhole puncture and to explore its application effect in hemodialysis patients.Methods Based on literature review and expert consultation,a management program for difficult autologous arteriovenous fistula buttonhole puncture was developed.A buttonhole puncture information handover sheet and a buttonhole puncture diagram were designed.A total of 77 hemodialysis patients with difficult autologous arteriovenous fistula treated in the blood purification center of a tertiary hospital in Zhejiang Province from September 2020 to January 2022 were selected as the study subjects.They were randomly divided into the experimental group(n=38)and the control group(n=39)using a random number table.The experimental group received the management program for difficult autologous arteriovenous fistula buttonhole puncture,while the control group received the conventional buttonhole puncture program.The success rate of one-time blunt needle insertion,arteriovenous fistula infection rate,vascular intimal hyperplasia at the buttonhole puncture site,and buttonhole with a service life of ≥12 months rate were compared between the two groups.Results The success rate of one-time blunt needle insertion in the experimental group was higher than that in the control group,the degree of vascular intimal hyperplasia at the buttonhole puncture site was lower than that in the control group,and the buttonhole with a service life of ≥12 months rate was higher than that in the control group(P＜0.05).There was no significant difference in the arteriovenous fistula infection rate between the two groups(P＞0.999).Conclusion The application of the management program for difficult autologous arteriovenous fistula buttonhole puncture in hemodialysis patients can improve the success rate of one-time blunt needle insertion,delay vascular intimal hyperplasia at the buttonhole puncture site,and prolong the service life of arteriovenous fistula buttonholes,which is worthy of promotion and application.
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