Effects of integrated comprehensive management model in the management of arteriovenous fistula in maintenance hemodialysis patients
10.3760/cma.j.cn115682-20211017-04687
- VernacularTitle:一体化综合管理模式在维持性血液透析患者动静脉内瘘管理中的应用效果
- Author:
Tao WANG
1
;
Tiantian XU
;
Yan WANG
;
Xiaona LIU
;
Xiaohong YUE
;
Jinhong MIAO
Author Information
1. 郑州大学第一附属医院血液净化中心，郑州 450000
- Keywords:
Dialysis;
Maintenance hemodialysis;
Vascular access;
Integration;
Comprehensive management
- From:
Chinese Journal of Modern Nursing
2022;28(23):3133-3137
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To explore the effect of integrated comprehensive management model in the management of arteriovenous fistula in maintenance hemodialysis (MHD) patients.Methods:From January to December 2020, 174 patients undergoing MHD in the Blood Purification Center of the First Affiliated Hospital of Zhengzhou University were selected as the research object by convenience sampling. According to the random number table method, the patients were divided into the integrated management group and the routine management group, with 87 cases in each group. Patients in the routine management group received routine vascular access nursing after admission. On the basis of routine vascular access nursing, the integrated management group introduced a multidisciplinary vascular access management team to apply it to the access management of MHD patients, and divided the vascular access management into five key links of preoperative assessment, access establishment, access use, access monitoring and access maintenance, and formulated specific measures and content for each link to implemented an integrated comprehensive management model. After three months of intervention, the successful rate of one-time puncture, the use rate of the first dialysis internal fistula, the incidence of associated complications and dialysis tolerance were compared between the two groups.Results:The one-time puncture success rate and the first dialysis internal fistula usage rate in the integrated management group were higher than those in the routine management group, and the differences were statistically significant ( P<0.05) . The overall complication rate in the integrated management group was 6.90% (6/87) , which was lower than 31.03% (27/87) in the routine management group, and the difference was statistically significant (χ 2=16.491, P<0.01) . The scores of the two parts and total scores of the dialysis tolerance in the integrated management group were higher than those in the routine management group, and the difference was statistically significant ( P<0.05) . Conclusions:The integrated comprehensive management model applied in the management of vascular access in MHD patients can increase the one-time puncture success rate of arteriovenous fistula and the use rate of the first dialysis fistula, reduce the incidence of associated complications, and improve patient tolerance.
