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目的观察锐针阶梯穿刺法与钝针定点穿刺法对血液透析内瘘血管内膜增生的影响。方法选取2014年4月至2015年4月维持性血液透析的患者60例作为研究对象,并随机分为2组。锐针阶梯穿刺组32例给予锐针阶梯穿刺法穿刺,钝针定点穿刺组28例给予钝针定点穿刺法穿刺,2组血管通路为上肢前臂自体动-静脉内瘘,穿刺前明确内瘘成熟。2组方法均使用1年后,通过B超观察各穿刺点血管厚度,取其各穿刺点厚度平均值进行评估,比较血管增生情况;选取吻合口处血流量比较血流情况。结果钝针定点穿刺组血管壁厚度明显增加,与治疗前比较差异有统计学意义(P<0.05),且血管壁增厚程度显著大于锐针阶梯穿刺组(P<0.05);2组治疗前后血流量比较差异无统计学意义(P>0.05)。结论锐针阶梯穿刺法较钝针定点穿刺法更能减少血管增生,保护血管内膜,值得临床推广。
Objective To observe the effects of acute needle ladder puncture and blunt needle puncturing on intimal hyperplasia of hemodialysis fistula. Methods Sixty patients with maintenance hemodialysis from April 2014 to April 2015 were selected as the study subjects and randomly divided into two groups. 32 cases of sharp-needle ladder puncture were treated with sharp-needle ladder puncture, 28 cases of punctured needle punctured with blunt punctures were punctured with blunt-pin fixed puncture, 2 vessels were autologous arteriovenous fistula of forearm forearm, . One year after the two methods were used, the thickness of blood vessels at each puncture point was observed by B-mode ultrasound, and the thickness of each puncture point was averaged to evaluate the vascular proliferation. The blood flow of the anastomosis was compared with that of blood flow. Results The thickness of the vascular wall in the fixed needle puncture group was significantly increased (P <0.05), and the degree of vascular wall thickening was significantly greater than that of the sharp-needle ladder puncture group (P <0.05). Before and after treatment Blood flow difference was not statistically significant (P> 0.05). Conclusions Stereoscopic needle puncture is more effective than blunt needle puncturing to reduce vascular hyperplasia and protect vascular intima, which is worthy of clinical promotion.