维持性血液透析患者自体动静脉内瘘瘤样扩张防治不足影响因素的质性研究

doi:10.3760/cma.j.cn441417-20241114-09029

国际医药卫生导报 ›› 2025, Vol. 31 ›› Issue (9): 1559-1564.DOI: 10.3760/cma.j.cn441417-20241114-09029

维持性血液透析患者自体动静脉内瘘瘤样扩张防治不足影响因素的质性研究

陈春桃¹^，² 区秀丽³ 李彩霞⁴ 刘彩玲⁵ 曾娜芬⁶ 杜真萍⁷ 蔡少娜⁷ 米谦⁷ 符霞⁴

¹中山大学护理学院，广州 510000；²江门市中心医院重症医学科，江门 529000；³江门市中心医院护理部，江门 529000；⁴中山大学附属第八医院护理部，深圳 518000；⁵江门市中心医院血液净化中心，江门 529000；⁶中山大学附属第八医院手术室，深圳 518000；⁷广东药科大学护理学院，广州 510000

收稿日期:2024-11-14 出版日期:2025-05-01 发布日期:2025-05-20
通讯作者: 符霞，Email：fuxia5@mail.sysu.edu.cn
基金资助:
广东省卫济医学发展基金会2024年肾脏替代治疗专项科研基金（K-20240107）；广东省护理学会2023年护理创新发展研究基金（GDHLYJYZ202303）

Qualitative study on influencing factors of inadequate prevention and treatment of autologous arteriovenous fistula-like dilation in maintenance hemodialysis patients

Chen Chuntao^1,2, Ou Xiuli³, Li Caixia⁴, Liu Cailing⁵, Zeng Nafen⁶, Du Zhenping⁷, Cai Shaona⁷, Mi Qian⁷, Fu Xia⁴

¹School of Nursing, Sun Yat-sen University, Guangzhou 510000, China; ²Department of Critical Care Medicine, Jiangmen Central Hospital, Jiangmen 529000, China; ³Nursing Department, Jiangmen Central Hospital, Jiangmen 529000, China; ⁴Nursing Department, The Eighth Affiliated Hospital of Sun Yat-sen University, Shenzhen 518000, China; ⁵Blood Purification Center, Jiangmen Central Hospital, Jiangmen 529000, China; ⁶The Operating Room, The Eighth Affiliated Hospital of Sun Yat-sen University, Shenzhen 518000, China;⁷School of Nursing, Guangdong Pharmaceutical University, Guangzhou 510000, China

Received:2024-11-14 Online:2025-05-01 Published:2025-05-20
Contact: Fu Xia, Email: fuxia5@mail.sysu.edu.cn.
Supported by:
Project of Renal Replacement Therapy Special Research Fund of Guangdong Weiji Medical Development Foundation in 2024 K-20240107); Project of Nursing Innovation and Development Research Fund of Guangdong Nursing Association in 2023(GDHLYJYZ202303

摘要/Abstract

摘要：

目的　探讨维持性血液透析患者自体动静脉内瘘瘤样扩张防治不足的影响因素。方法　本研究为质性研究的现象学研究法。采用目的抽样法，于2024年5—6月选取8所医疗机构的18名医护人员及其中1所医疗机构的10名维持性血液透析患者进行半结构访谈，根据Colaizzi 7步分析法对访谈资料进行整理和分析。结果　共进行28次一对一访谈，每位受访者访谈时长为20～60 min，均未进行第2次访谈。提炼出3个主题和6个亚主题，3个主题分别为医护支持度不足、患者居家自我管理知识缺乏及家庭支持不足、组织系统不足。结论　维持性血液透析患者自体动静脉内瘘瘤样扩张防治不足存在3大阻碍因素，建议加强医护指导与穿刺规范，提升患者自我管理，优化管理制度以及增加人力资源投入，以提高自体动静脉内瘘瘤样扩张防治效果。

关键词: 慢性肾脏病； , , 维持性血液透析； , , 自体动静脉内瘘； , , 瘤样扩张； , , 防治效果； , , 质性研究

Abstract:

Objective　To explore the influencing factors of insufficient prevention and treatment of aneurysmal dilatation of arteriovenous fistula in maintenance hemodialysis patients. Methods　This study is a phenomenological research method of qualitative research. Objective sampling method was used, from May to June 2024,18 medical staff from 8 medical institutions and 10 maintenance hemodialysis patients from 1 medical institution were selected for semi-structured interviews. The interview data were collated and analyzed according to Colaizzi 's seven-step analysis method. Results　A total of 28 one-on-one interviews were conducted. The length of each interview was 20-60 min, and no second interview was conducted. Three themes and six sub-themes were extracted. The three themes were insufficient medical support, lack of knowledge of patients ' home self-management, insufficient family support, and insufficient organizational system. Conclusions　There are three major obstacles to the prevention and treatment of aneurysmal dilatation of arteriovenous fistula in maintenance hemodialysis patients. It is suggested to strengthen medical guidance and puncture norms, improve patient self-management, optimize management system and increase human resource investment to improve the prevention and treatment of aneurysmal dilatation of arteriovenous fistula.

Key words: Chronic kidney disease, Maintenance hemodialysis, Autogenous arteriovenous fistula, Tumor-like dilatation, Control efficiency, Qualitative research

陈春桃区秀丽李彩霞刘彩玲曾娜芬杜真萍蔡少娜米谦符霞.

维持性血液透析患者自体动静脉内瘘瘤样扩张防治不足影响因素的质性研究 [J]. 国际医药卫生导报, 2025, 31(9): 1559-1564.

Chen Chuntao, Ou Xiuli, Li Caixia, Liu Cailing, Zeng Nafen, Du Zhenping, Cai Shaona, Mi Qian, Fu Xia.

Qualitative study on influencing factors of inadequate prevention and treatment of autologous arteriovenous fistula-like dilation in maintenance hemodialysis patients [J]. International Medicine and Health Guidance News, 2025, 31(9): 1559-1564.

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维持性血液透析患者自体动静脉内瘘瘤样扩张防治不足影响因素的质性研究

Qualitative study on influencing factors of inadequate prevention and treatment of autologous arteriovenous fistula-like dilation in maintenance hemodialysis patients

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