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| 基于奥瑞姆自我护理理论的B超引导下动静脉内瘘穿刺规范化护理方案构建及回顾性临床应用研究 |
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| 投稿时间：2026-04-15 修订日期：2026-05-19 |
| DOI： |
| 中文关键词: 奥瑞姆自我护理理论 B超引导 动静脉内瘘穿刺 规范化护理 维持性血液透析 回顾性研究 |
| 英文关键词:Orem’s self-care theory ultrasound guidance arteriovenous fistula puncture standardized nursing maintenance hemodialysis retrospective study |
| 基金项目:回顾性观察超声引导下穿刺技术在血透患者中的安全性分析,北京京煤集团总医院院级科研项目(ZZ2024-49),国家医学研究登记备案号：MR-11-25-003133 |
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| 中文摘要: |
| 目的 构建基于奥瑞姆自我护理理论(SCDNT)的B超引导下动静脉内瘘穿刺规范化护理方案,并验证其临床效果。方法 通过证据整合及临床需求评估、半结构访谈、德尔菲专家咨询构建基于奥瑞姆自我护理理论的B超引导下动静脉内瘘穿刺规范化护理方案。采用回顾性研究,选取北京京煤集团总医院血液透析科2023年10月—2024年8月170例维持性血液透析动静脉内瘘患者,按护理方案实施时间分为对照组(常规护理85例)与观察组(规范化护理85例)。比较两组穿刺一次成功率、穿刺并发症、护理意外事件发生率,采用自我护理能力量表(ESCA)评估自我护理能力,同时对比内瘘使用寿命及护理满意度。结果 观察组穿刺一次成功率(97.65%)、自我护理能力评分(128.64±10.32)、护理满意度(96.47%)均高于对照组(88.24%、112.35±11.58、82.35%),穿刺并发症总发生率(3.53%)、护理意外事件总发生率(2.35%)均低于对照组(14.12%、10.59%),内瘘使用寿命长于对照组,差异均有统计学意义(均P＜0.05)。结论 基于奥瑞姆自我护理理论的B超引导下动静脉内瘘穿刺规范化护理方案,可有效提高穿刺成功率,降低不良事件发生风险,提升患者自我护理能力,延长内瘘使用寿命,临床推广价值较高。 |
| 英文摘要: |
| Objective To construct a standardized nursing protocol for ultrasound-guided arteriovenous fistula puncture based on Orem’s Self-Care Deficit Nursing Theory (SCDNT), and to verify its clinical efficacy. Methods The standardized nursing protocol was established through evidence integration, clinical needs assessment, semi-structured interviews, and Delphi expert consultation. A retrospective study was conducted, enrolling 170 maintenance hemodialysis patients with arteriovenous fistula in the Hemodialysis Department of Beijing Jingmei Group General Hospital from October 2023 to August 2024. According to the implementation time of the nursing protocol, patients were divided into a control group (85 cases receiving routine nursing) and an observation group (85 cases receiving standardized nursing). The first-attempt puncture success rate, incidence of puncture complications and nursing accidents were compared between the two groups. The Exercise of Self-Care Agency Scale (ESCA) was used to evaluate self-care ability. Meanwhile, the service life of arteriovenous fistula and nursing satisfaction were compared. Results The observation group had higher first-attempt puncture success rate (97.65%), self-care ability score (128.64±10.32) and nursing satisfaction (96.47%) than the control group (88.24%, 112.35±11.58, 82.35%). The total incidence of puncture complications (3.53%) and nursing accidents (2.35%) in the observation group were lower than those in the control group (14.12%, 10.59%), and the service life of arteriovenous fistula was longer, with statistically significant differences (all P＜0.05). Conclusion The standardized nursing protocol for ultrasound-guided arteriovenous fistula puncture based on Orem’s Self-Care Deficit Nursing Theory can effectively improve the puncture success rate, reduce the risk of adverse events, enhance patients’ self-care ability, and prolong the service life of arteriovenous fistula, which is worthy of wide clinical application. |
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