Florence Nightingale Hospital School of Nursing, Demiroglu Bilim University, Istanbul, Turkey.
Department of Nursing, Hasan Kalyoncu University Faculty of Health Sciences, Gaziantep, Turkey.
Hemodial Int. 2022 Oct;26(4):503-508. doi: 10.1111/hdi.13044. Epub 2022 Sep 6.
This study aimed to investigate the effect of the bevel orientation (facing upwards or downwards towards the skin) of the needle inserted into the arterial limb of the arteriovenous fistula (AVF) on puncture pain and postremoval bleeding time.
This study, using a single-blind crossover design, was conducted on 35 maintenance hemodialysis patients who had been dialyzed for at least 6 months and in whom blood access was via an AVF. AVF cannulation was performed with the needle bevel pointing upward in the first six sessions and the needle bevel pointing downwards (towards the skin) in the subsequent six sessions. Needles were always inserted in the direction of blood flow. At each dialysis session, cannulation pain was measured using a visual analog scale (VAS), and the bleeding time at the end of dialysis after needle removal was recorded.
The VAS score and postremoval bleeding time were lower when the needle bevel pointed downwards towards the skin during insertion (P < 0.05).
Insertion of the needle with the bevel pointed downward decreased puncture pain during cannulation and bleeding time postdialysis on needle removal.
本研究旨在探讨将动脉穿刺针插入动静脉瘘（AVF）动脉分支时的针尖斜面朝向（向上或向下朝向皮肤）对穿刺疼痛和拔针后出血时间的影响。
本研究采用单盲交叉设计，纳入了 35 名至少接受 6 个月血液透析且通过 AVF 进行血液通路的维持性血液透析患者。在前 6 次治疗中，将针尖斜面向上插入 AVF，在随后的 6 次治疗中，针尖斜面向下（朝向皮肤）插入 AVF。所有的针都沿着血流方向插入。在每次透析治疗中，使用视觉模拟评分（VAS）测量穿刺疼痛，记录透析结束时拔针后的出血时间。
针尖斜面向下插入时，VAS 评分和拔针后出血时间更低（P < 0.05）。
针尖斜面朝下插入可减少穿刺过程中的疼痛，并降低透析结束时拔针后的出血时间。
