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引导式想象技术与冷冻疗法对血液透析患者动静脉血管穿刺时疼痛强度影响的比较:一项交叉临床试验。

Comparison of the effect of guided visualization technique and cryotherapy on pain intensity during needle insertion into arterial-venous vessels of hemodialysis undergoing patients: A cross-over clinical trial.

作者信息

Ghazanfari Zahra, Teshnizi Saeed H, Yousefi Pooneh, Faghih Aref

机构信息

Department of Nursing, Student Research Committee, Hormozgan University of Medical Sciences, Bandar Abbas, Iran.

Mother and Child Welfare Research Center, Hormozgan University of Medical Sciences, Bandar Abbas, Iran.

出版信息

J Educ Health Promot. 2025 Feb 28;14:79. doi: 10.4103/jehp.jehp_232_24. eCollection 2025.

DOI:10.4103/jehp.jehp_232_24
PMID:40144165
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11940062/
Abstract

BACKGROUND

End-stage renal disease patients experience pain during needle insertion each time they undergo vascular access. This pain is the most severe aspect of hemodialysis-related stress. Based on this, this study was conducted with the aim of the effect of guided visualization technique and cryotherapy on the intensity of pain when the needle enters the arterialvenous vessels in patients undergoing hemodialysis.

MATERIALS AND METHODS

This cross-over clinical trial was conducted on 60 patients undergoing hemodialysis from September to December 2023. Patients were randomly assigned to three independent groups ( = 20 people per group). This study was conducted in three stages, during which each group received guided visualization, cryotherapy, and routine care (control) separately. Pain intensity was measured individually using the numerical rating scale at the end of each interventions. Data analysis was performed using data statistics (Stata) version 14 and Statistical Package for the Social Science version 26.

RESULTS

The results showed that guided visualization significantly outperformed cryotherapy across all three groups and stages. Additionally, both guided visualization and cryotherapy significantly outperformed the control group in reducing pain following needle insertion in patients undergoing hemodialysis.

CONCLUSION

Guided visualization can be used as a safe and secure method to reduce pain when the needle enters the arteriovenous fistula in patients undergoing hemodialysis.

TRIAL REGISTRATION NUMBER

IRCT202308080590. (21/08/2023).

摘要

背景

终末期肾病患者每次进行血管通路建立时都会在针头插入过程中经历疼痛。这种疼痛是血液透析相关应激中最严重的方面。基于此,本研究旨在探讨引导式想象技术和冷冻疗法对血液透析患者针头进入动静脉血管时疼痛强度的影响。

材料与方法

本交叉临床试验于2023年9月至12月对60例血液透析患者进行。患者被随机分为三个独立组(每组20人)。本研究分三个阶段进行,在此期间,每组分别接受引导式想象、冷冻疗法和常规护理(对照组)。在每次干预结束时,使用数字评分量表单独测量疼痛强度。使用数据统计软件(Stata)版本14和社会科学统计软件包版本26进行数据分析。

结果

结果表明,在所有三组和三个阶段中,引导式想象均显著优于冷冻疗法。此外,在减轻血液透析患者针头插入后的疼痛方面,引导式想象和冷冻疗法均显著优于对照组。

结论

引导式想象可作为一种安全可靠的方法,用于减轻血液透析患者针头进入动静脉内瘘时的疼痛。

试验注册号

IRCT202308080590。(2023年8月21日)

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本文引用的文献

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Dialysis Needle-Related Distress: Patient Perspectives on Identification, Prevention, and Management.透析针相关困扰:患者对识别、预防和管理的看法
Kidney Int Rep. 2023 Sep 14;8(12):2625-2634. doi: 10.1016/j.ekir.2023.09.011. eCollection 2023 Dec.
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The Effect of Acupressure and Cryotherapy on the Pain of Patients on Hemodialysis During Arteriovenous Fistula Cannulation: A Randomized Crossover Clinical Trial.指压疗法与冷冻疗法对动静脉内瘘穿刺时血液透析患者疼痛的影响:一项随机交叉临床试验
Nephrol Nurs J. 2023 Mar-Apr;50(2):131-139.
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Factors Affecting Pain in Hemodialysis and Non-pharmacological Management.
血液透析中影响疼痛的因素及非药物管理
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Functional and Kinetic Treatment With Rehabilitation Combined With Cryotherapy Compared to Cryotherapy Alone in the Treatment of Acute Grade I or II Inversion Ankle Sprains: A Randomized Clinical Trial.与单纯冷冻疗法相比,功能和动力学康复联合冷冻疗法治疗急性I级或II级内翻性踝关节扭伤的随机临床试验
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Effect of cilostazol on arteriovenous fistula in hemodialysis patients.西洛他唑对血液透析患者动静脉瘘的影响。
Nefrologia (Engl Ed). 2021 Nov-Dec;41(6):625-631. doi: 10.1016/j.nefroe.2022.01.006.
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Fatigue, stigma, and mood in patients with multiple sclerosis: effectiveness of guided imagery.多发性硬化症患者的疲劳、耻辱感和情绪:引导式意象的有效性
BMC Neurol. 2022 Apr 22;22(1):152. doi: 10.1186/s12883-022-02677-3.
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The effect of Hugo point acupressure massage on respiratory volume and pain intensity due to deep breathing in patients with chest tube after chest surgeries.胡果点穴位按摩对胸部手术后带胸管患者深呼吸时呼吸量及疼痛强度的影响。
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The effect of guided imagery on the quality and severity of pain and pain-related anxiety associated with dressing changes in burn patients: A randomized controlled trial.引导式意象对烧伤患者换药时疼痛的质量、严重程度及疼痛相关焦虑的影响:一项随机对照试验。
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