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

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

International Medicine and Health Guidance News ›› 2025, Vol. 31 ›› Issue (9): 1559-1564.DOI: 10.3760/cma.j.cn441417-20241114-09029

• Nursing Research • Previous Articles Next Articles

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

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

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）

Abstract

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

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

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.

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.

References

[1] Duan J, Wang C, Liu D, et al. Prevalence and risk factors of chronic kidney disease and diabetic kidney disease in Chinese rural residents: a cross-sectional survey[J]. Sci Rep, 2019, 9(1): 10408. DOI: 10.1038/s41598-019- 46857-7.

[2] Wouk N. End-Stage renal disease: medical management[J]. Am Fam Physician, 2021, 104(5):493-499.

[3] Yan Q, Davies MG. Outcomes of one-stage and two-stage aneurysm repair in arteriovenous fistulae[J]. J Vasc Surg, 2024, 79(3): 662-670.e3. DOI: 10.1016/j.jvs.2023.10.057.

[4] Janeckova J, Bachleda P, Koleckova M, et al. Brachial artery aneurysm as a late complication of arteriovenous fistula[J]. J Vasc Access, 2023, 24(5): 926-932. DOI: 10.1177/11297298211059326.

[5]王红,王佳佳,单岩,等. 郑州市中青年血液透析患者应对效能在感知控制与自我管理间的中介效应分析[J]. 医学与社会,2022,35(6):121-126. DOI:10.13723/j.yxysh.2022. 06.023.

[6]许娴,马少娜,关锦美. 血液透析患者自我管理水平与疾病感知及希望水平相关性研究[J]. 中国中西医结合肾病杂志,2021,22(10):916-918. DOI:10.3969/j.issn.1009- 587X. 2021.10.021.

[7]田远如,孙晓敏,魏亚琼. 内瘘专项护理小组在动静脉内瘘假性动脉瘤患者中的作用[J]. 国际医药卫生导报,2024,30(2):328-332. DOI:10.3760/cma.j.issn.1007-1245. 2024.02.031.

[8]高华,武佳唯,李新. 彩超评测血液透析患者自体动静脉内瘘瘘口及血流速度的价值[J]. 国际医药卫生导报,2024,30(6):957-962. DOI:10.3760/cma.j.issn.1007-1245. 2024.06.016.

[9] Abreo K, Amin BM, Abreo AP. Physical examination of the hemodialysis arteriovenous fistula to detect early dysfunction[J]. J Vasc Access, 2019, 20(1): 7-11. DOI: 10.1177/1129729818768183.

[10]闫博,岳庆雄. 彩色多普勒超声肱动脉血流量/肱动脉阻力指数评价动静脉内瘘狭窄的价值[J]. 中国血液净化,2023,22(4):302-305. DOI:10.3969/j.issn.1671-4091. 2023.04.012.

[11]路景画,陶惠琴,张洁婷,等. 306例维持性血液透析患者自体动静脉内瘘穿刺部位瘤样扩张现状及影响因素分析[J]. 护理学报,2024,31(10):59-63. DOI:10.16460/j.issn1008- 9969.2024.10.059.

[12]潘玲. 内瘘穿刺计划表在自体动静脉内瘘绳梯穿刺法中的应用效果[J]. 福建医药杂志,2022,44(6):169-170. DOI:10.3969/j.issn.1002-2600.2022.06.062.

[13]姚芳,刘清燕,唐婷,等. 个性化血管穿刺图谱在维持性血液透析患者动静脉内瘘中的应用[J]. 河北医药,2024,46(8):1278-1280. DOI:10.3969/j.issn.1002-7386.2024.08.036.

[14]张艳,姜惠丽,张慧竹,等. 维持性血液透析患者液体摄入行为现状及影响因素分析[J]. 中国血液净化,2024,23(4):256-260. DOI:10.3969/j.issn.1671-4091.2024.04.004.

[15]曾冬梅,肖贵珍,肖冰,等. 个体强化及集体分享交替教育模式在血透患者高钾血症控制中的应用[J]. 黑龙江医学,2020,44(11):1589-1591. DOI:10.3969/j.issn.1004-5775. 2020.11.043.

[16]曹莉,葛玉英,袁潇,等. 微信随访在自体动静脉内瘘血透患者中的应用研究[J]. 医院管理论坛,2020,37(9):71-74. DOI:10.3969/j.issn.1671-9069.2020.09.023.

[17]付闯. 维持性血液透析患者家庭照顾者负担与生活质量的相关性研究[D]. 郑州:河南大学,2018.

[18]周梦祎,张华雪,肖雅倩. 护士主导家属参与下营养护理干预对维持性血液透析患者营养状态、生活质量的影响[J]. 齐鲁护理杂志,2024,30(17):59-61. DOI:10.3969/j.issn. 1006-7256.2024.17.017.

[19]林芷珊,陈晓敏,黄白茹,等. 阶段性康复教育对维持性血透患者自我管理行为及相关知识认知的影响[J]. 黑龙江医学,2021,45(16):1696-1697. DOI:10.3969/j.issn.1004-5775. 2021.16.006.

[20] Peralta R, Sousa L, Cristovão AF. Cannulation technique of vascular access in hemodialysis and the impact on the arteriovenous fistula survival: systematic review and meta-analysis[J]. J Clin Med, 2023, 12(18): 5946. DOI: 10.3390/jcm12185946.

[21] Álvaro Cristóbal A, París Boal C, Blanco Velasco N, et al. Hemostasis of arteriovenous fistula: comparison of direct two-finger pressure to an adjustable device[J]. Nefrologia (Engl Ed), 2021, 41(5): 566-572. DOI: 10.1016/j.nefroe.2021.12.001.

[22] Perez-Dominguez B, Casaña-Granell J, Garcia-Maset R, et al. Effects of exercise programs on physical function and activity levels in patients undergoing hemodialysis: a randomized controlled trial[J]. Eur J Phys Rehabil Med, 2021, 57(6): 994-1001. DOI: 10.23736/S1973-9087. 21.06694-6.

[23] Zuo M, Zhu W, Lin J, et al. The impact of nurse-led nonpharmacological multidisciplinary holistic nursing care on fatigue patients receiving hemodialysis: a randomized, parallel-group, controlled trial[J]. BMC Nurs, 2022, 21(1): 352. DOI: 10.1186/s12912-022-01126-3.

[24]罗丽敏. 基于循证构建血透患者动静脉内瘘合并动脉瘤的管理方案及应用研究[D]. 郑州:郑州大学,2020.

[25]雷雨田. 血管通路协调员主导的自体动静脉内瘘多学科管理方案的构建与应用[D]. 郑州:郑州大学,2022.

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

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

Knowledge

Abstract

Cite this article

share this article

References

Related Articles 15

Recommended Articles

Metrics

[1]	Gu Yunyun, Gu Jin, Sun Dunpo, Wang Yisong, Li Jing. Association of uric acid to albumin ratio with cardiovascular and cerebrovascular events in patients with chronic kidney disease taking peritoneal dialysis [J]. International Medicine and Health Guidance News, 2025, 31(6): 1020-1026.
[2]	Tang Fang, Zou Tao, Luo Shimiao, Wu Xiaona, Jie Xina, Fu Lizhe, Qin Xindong, Deng Lili, Wu Yifan. Construction of an evaluation index system of the health education on chronic kidney disease [J]. International Medicine and Health Guidance News, 2025, 31(5): 746-751.
[3]	Guo Zhimei, Wang Mingming. Effect of multidisciplinary collaborative care for elderly patients with diabetic nephropathy and sarcopenia undergoing maintenance hemodialysis [J]. International Medicine and Health Guidance News, 2025, 31(2): 208-213.
[4]	Zheng Haiying, Chen Xiaoqing, Shao Yixin, Lu Suhong, Sun Wenli, Huang Chunhong. Application of CBL and workshop teaching mode in teaching nutritional management of chronic kidney disease to nursing interns [J]. International Medicine and Health Guidance News, 2025, 31(2): 345-349.
[5]	Wang Xia, Zhang Lingyun, Song Shoujun, Xu Hongxin. Effects of finerenone versus SGLT2 inhibitors on cardiovascular events in patients with type 2 diabetes mellitus and/or chronic kidney disease [J]. International Medicine and Health Guidance News, 2024, 30(5): 781-788.
[6]	Xiong Hui, Chen Zhuomin, Wan Xiaohui, Pan Jie, Zhang Jing, Xie Kaixuan, Liu Nana, Nie Ronglu. Effect of stepped grip strength exercise on patients with forearm hypervascularity of stage 4 chronic kidney disease [J]. International Medicine and Health Guidance News, 2024, 30(19): 3278-3281.
[7]	Luo Yehua, Zhou Hongming, Guo Qi, Dong Jingjing, Zhang Juanjuan, Yin Lianghong. Development of a machine learning model for predicting intradialytic hypotension [J]. International Medicine and Health Guidance News, 2024, 30(17): 2856-2862.
[8]	Zhou Mi, Li Jianfeng, Yu Fei. Color Doppler ultrasound guided balloon dilation for arteriovenous fistula stenosis of patients with uremia taking maintenance hemodialysis [J]. International Medicine and Health Guidance News, 2024, 30(15): 2553-2557.
[9]	Li Xinmeng, Liu Qianqian, Liu Yunqi. Risk factors and delay strategies for progression of chronic kidney disease [J]. International Medicine and Health Guidance News, 2024, 30(11): 1766-1770.
[10]	Chen Wenqing, Guan Baozhang. Research progress on diabetic nephropathy complicated with pregnancy [J]. International Medicine and Health Guidance News, 2024, 30(1): 15-20.
[11]	Zhou Hongming, Li Yunyi, Li Weilong, Song Zhuoheng, Chen Yu, Cao Rui, Hu Bo, Luan Shaodong, Yin Lianghong. Advances in the application of machine learning in hemodialysis treatment [J]. International Medicine and Health Guidance News, 2023, 29(13): 1777-1781.
[12]	Mei Jiahui, Lou Huankun, Wang Xun, Han Cuimin, Li Peng, Xing Tuanjie, Wang Minglang, Wang Yilian. Association between ApoE gene polymorphism and ADMA level in patients with chronic kidney disease [J]. International Medicine and Health Guidance News, 2022, 28(8): 1047-1052.
[13]	Wei Feiyuan, Guo Junjun, Gu Juan, Wu Dongming, Xue Leyi, Wang Lingzhen, Tang Fang, Deng Lili. Investigation and analysis of the demands for popular science and health information in patients with chronic kidney disease [J]. International Medicine and Health Guidance News, 2022, 28(8): 1052-1057.
[14]	Li Rugang, Huang Jieping, Kuang Shuanghong, Liang Zezhi, Zhong Jinghua. Clinical observation on the effect of sodium zirconium cyclosilicate powder on short-term potassium lowering in patients with severe hyperkalemia of chronic kidney disease [J]. International Medicine and Health Guidance News, 2022, 28(6): 854-858.
[15]	Gao Min, Li Qijun, Jiang Wengong, Lyu Lu. Relationship between red blood cell distribution width and left ventricular diastolic dysfunction in patients with chronic kidney diseases [J]. International Medicine and Health Guidance News, 2022, 28(4): 453-458.