Adib-Hajbagheri Mohsen, Molavizadeh Narjes, Alavi Negin Masoodi, Abadi Mahmood Hosseiny Mosa
Department of Medical Surgical Nursing, Faculty of Nursing and Midwifery, Kashan University of Medical Sciences, Kashan, Iran.
Department of critical care Nursing, Noor and Aliasghar Hospital, Esfahan Universiy of Medical Sciences, Esfahan, Iran.
Iran J Nurs Midwifery Res. 2014 Mar;19(2):208-14.
Vascular access complications are a major cause of excessive morbidity and mortality in the dialysis population. Moreover, there is not sufficient research regarding the factors correlated with vascular access complications among hemodialysis patients. This study aimed to evaluate the vascular access complications and their related factors such as nursing techniques and self-care in hemodialysis patients.
A cross-sectional study was performed on 110 patients undergoing hemodialysis in Isfahan Aliasghar hospital during 9 months from July 2010 to March 2011. The data collection tools were a demographic questionnaire and three checklists designed to assess the complications of vascular access and care techniques. Data were collected by observations and interviews with the patients. Fisher's exact test, chi-square test, Pearson correlation coefficient, and descriptive statistics were used to analyze the data through SPSS 16.
Among 110 subjects, there were 63 male and 47 female subjects. Subjects' mean age was 55.88 (15.51) years. There were 72 patients undergoing hemodialysis through arteriovenous fistula and 38 through permanent intra-jugular catheters. Insufficient blood flow in the catheter was the most common complication in patients with jugular catheters. Also, aneurysm was the most prevalent complication in patients with arteriovenous fistula. Low self-care of patients and needling into the aneurysm were correlated with aneurysm size. Presence of underlying diseases was related to ischemia.
Nursing techniques and self-care of patients were correlated with the occurrence of complications. Therefore, it draws the attention of the nurses toward continuing professional education and patients' education, which can increase the longevity of vascular access.
血管通路并发症是透析人群发病率和死亡率过高的主要原因。此外，关于血液透析患者血管通路并发症相关因素的研究并不充分。本研究旨在评估血液透析患者的血管通路并发症及其相关因素，如护理技术和自我护理。
2010年7月至2011年3月的9个月期间，对伊斯法罕阿利亚斯加尔医院110例接受血液透析的患者进行了一项横断面研究。数据收集工具包括一份人口统计学调查问卷和三份用于评估血管通路并发症和护理技术的检查表。通过观察和与患者访谈收集数据。使用Fisher精确检验、卡方检验、Pearson相关系数和描述性统计通过SPSS 16对数据进行分析。
110名受试者中，男性63名，女性47名。受试者的平均年龄为55.88（15.51）岁。72例患者通过动静脉内瘘进行血液透析，38例通过永久性颈内静脉导管进行透析。导管血流量不足是颈内静脉导管患者最常见的并发症。此外，动脉瘤是动静脉内瘘患者最常见的并发症。患者自我护理不足和针刺动脉瘤与动脉瘤大小相关。基础疾病的存在与缺血有关。
护理技术和患者的自我护理与并发症的发生相关。因此，这引起了护士对持续专业教育和患者教育的关注，这可以延长血管通路的使用寿命。
