Abstract:

Objective　To investigate the effect of safflower wine wet compressing on the function and complications of early arteriovenous fistula in hemodialysis patients. Methods　This study was a randomized controlled trial. A total of 60 patients who underwent regular maintenance hemodialysis with new internal fistula in the Blood Purification Center of Guangzhou First People's Hospital from January to December 2022 were selected as the study objects. The patients were divided into a control group (30 cases) and an observation group (30 cases) by the random number table method. There were 12 males and 18 females in the control group, aged (54.31±7.51) years, with a body mass index (BMI) of (22.34±3.24) kg/m². There were 19 males and 11 females in the observation group, aged (55.42±8.23) years, with a BMI of (22.56±2.91) kg/m². The control group received routine nursing care, while the observation group received safflower wine wet compressing nursing care. Both groups underwent a 6-month nursing intervention period. The cephalic vein diameter and blood flow at the anastomosis were compared between the two groups before intervention and after 1, 3, and 6 months of intervention, as well as the internal fistula function grade after 6 months of intervention, the occurrence of complications, and the degree of puncture pain during intervention. Independent sample t test, χ² test, rank sum test, and mixed linear effect model were used. Results　The diameter of cephalic vein in the observation group was (3.84±0.46) cm, (4.44±0.35) cm, (4.93±0.26) cm, and (5.39±0.21) cm before intervention and after 1, 3, and 6 months of intervention, respectively, and the cephalic vein blood flow was (419.14±35.44) ml/min, (514.16±51.63) ml/min, (701.39±88.59) ml/min, and (897.53±121.76) ml/min, respectively. In the control group, the diameter of cephalic vein was (4.00±0.43) cm, (4.49±0.30) cm, (4.77±0.35) cm, and (5.15±0.21) cm before intervention and after 1, 3, and 6 months of intervention, respectively, and the cephalic vein blood flow was (404.26±31.07) ml/min, (544.80±50.12) ml/min, (689.44±88.52) ml/min, and (723.09±156.55) ml/min, respectively. The cephalic vein diameter and blood flow before intervention, after 1 month, and after 3 months were all lower than those after 6 months (all P<0.05). The cephalic vein diameter and blood flow in the control group were lower than those in the observation group (all P<0.05). After 6 months of intervention, the excellent and good rate of internal fistula function in the observation group was higher than that in the control group [76.67% (23/30) vs. 50.00% (15/30)] (P<0.05). During the intervention period, the total incidence of complications in the observation group was lower than that in the control group [16.67% (5/30) vs. 43.33% (13/30)] (P<0.05). The degree of puncture pain in the observation group was lower than that in the control group (P<0.05). Conclusion　Safflower wine wet compressing can significantly increase the cephalic vein diameter and venous blood flow of new arteriovenous fistula in hemodialysis patients, promote the maturation of internal fistula, improve the function of internal fistula, reduce the related complications, and alleviate the pain during puncture, which is suitable for application and promotion in hemodialysis patients.

Key words:

Hemodialysis, Arteriovenous fistula, Complications, Safflower wine, Wet compressing

摘要：

目的　探讨红花酒湿敷对血液透析患者早期动静脉内瘘功能及并发症的影响。方法　本研究为随机对照试验。选取2022年1月至12月在广州市第一人民医院血液净化中心行规律维持性血液透析的60例患者作为研究对象。采用随机数字表法，将患者分为对照组（30例）和观察组（30例）。对照组男12例，女18例；年龄（54.31±7.51）岁；体重指数（22.34±3.24）kg/m²。观察组男19例，女11例；年龄（55.42±8.23）岁；体重指数（22.56±2.91）kg/m²。对照组采用常规护理，观察组采用红花酒湿敷护理。两组均干预6个月。比较两组干预前和干预1、3、6个月后头静脉直径与吻合口处头静脉血流量，干预6个月后内瘘功能，干预期间并发症发生情况及穿刺疼痛程度。采用独立样本t检验、χ²检验、秩和检验、混合线性效应模型。结果　观察组干预前和干预1、3、6个月后头静脉直径分别为（3.84±0.46）cm、（4.44±0.35）cm、（4.93±0.26）cm、（5.39±0.21）cm，头静脉血流量分别为（419.14±35.44）ml/min、（514.16±51.63）ml/min、（701.39±88.59）ml/min、（897.53±121.76）ml/min；对照组干预前和干预1、3、6个月后头静脉直径分别为（4.00±0.43）cm、（4.49±0.30）cm、（4.77±0.35）cm、（5.15±0.21）cm，头静脉血流量分别为（404.26±31.07）ml/min、（544.80±50.12）ml/min、（689.44±88.52）ml/min、（723.09±156.55）ml/min。干预前、干预1个月后、干预3个月后头静脉直径均小于干预6个月后，头静脉血流量均低于干预6个月后（均P<0.05）；对照组头静脉直径小于观察组，头静脉血流量低于观察组（均P<0.05）。干预6个月后，观察组内瘘功能优良率［76.67%（23/30）］高于对照组［50.00%（15/30）］（P<0.05）。干预期间，观察组并发症总发生率［16.67%（5/30）］低于对照组［43.33%（13/30）］（P<0.05）；观察组穿刺疼痛程度低于对照组（P<0.05）。结论　红花酒湿敷可改善动静脉内瘘头静脉直径和头静脉血流量，促进新内瘘成熟，改善内瘘功能，减少并发症发生，减轻患者穿刺疼痛程度。

关键词:

血液透析, 动静脉内瘘, 并发症, 红花酒, 湿敷