Faratro Rose, Jeffries Janine, Nesrallah Gihad E, MacRae Jennifer M
University Health Network, Toronto, Ontario, Canada.
Hemodial Int. 2015 Apr;19 Suppl 1:S80-92. doi: 10.1111/hdi.12242.
Creating and maintaining a healthy vascular access is a critical factor in successful home hemodialysis (HD). This article aims to serve as a "how-to manual" regarding vascular access issues for both patients and health-care providers in a home HD program. This document outlines cannulation options for patients with arteriovenous access and describes troubleshooting techniques for potential complications; strategies are suggested to help patients overcome fear of cannulation and address problems associated with difficult cannulation. Technical aspects of central venous catheter care, as well as a guide to troubleshooting catheter complications, are covered in detail. Monitoring for access-related complications of stenosis, infection, and thrombosis is a key part of every home HD program. Key performance and quality indicators are important mechanisms to ensure patient safety in home HD and should be used during routine clinic visits.
建立并维持健康的血管通路是家庭血液透析（HD）成功的关键因素。本文旨在为家庭HD项目中的患者和医护人员提供一份关于血管通路问题的“操作手册”。本文档概述了动静脉通路患者的插管选项，并描述了潜在并发症的故障排除技术；建议了一些策略来帮助患者克服对插管的恐惧，并解决与困难插管相关的问题。详细介绍了中心静脉导管护理的技术方面以及导管并发症的故障排除指南。监测血管通路相关的狭窄、感染和血栓形成并发症是每个家庭HD项目的关键部分。关键性能和质量指标是确保家庭HD患者安全的重要机制，应在常规门诊就诊时使用。
