Effect Study Of Puncture With Hemodialysis Indwelling Needle On Autogenous Arteriovenous Fistula At Initial Stages

Objective To investigate tthe effect of puncture with hemodialysis indwelling needle on autogenous arteriovenous fistula(AVF)at initial stages during hemodialysis.Methods 90 End stage renal disease patients who had underwent AVF plasty surgery were divided into two groups randomly,named research group and control group.The patients in research group underwent puncture with hemodialysis indwelling needle on AVF for hemodialysis.The patients in control group underwent puncture with normal arterial rotating needle on AVF for hemodialysis.During the first 4 weeks(12 punctures),the one-time success rate of punture,the rate of hematoma,venous pressures and patient comfort level during hemodialysis were observed.Before the first punture and 4 weeks after thearpy,observed detected the AVF flow,the diameter,and the rate of hemadostenosis,thrombosis or occlusion.The basic-Fibroblast growth factor(b-FGF)level of peripheral serum were detected at the two Point-In-TimeResults 4 weeks after hemodialysis(12 punctures on AVF),the one-time success rate of research group and control group were 96.59%and 97.54%respectively(P=0.362).The hematoma occuring rate during puncture are 2.27%and 6.82%respectively(P=0.616).The hematoma occuring rate during hemodialysis of research group was 2.27%,better than control group(29.55%,P<0.001).The NRS(Numerical rating scale)pain score during puncture of research group was higher than that of control group(P<0.001).The comfort scale and limbs mobility score of research group was better than that of control group(P<0.001).The average time to achieve hemostasis after hemodialysis in research group was shorter than that in control group(P=0.049).The average venous pressure during hemodialysis in research group was lower than that in control group(P<0.001).There was one patient got AVF dysfunction in control group but no patient got in research group.The average AVF flow and b-FGF level of the two groups did not change after 4 weeks hemodialysisi therapy.There was no significant difference of the average AVF flow and b-FGF level between the two groups at same point-in-time.6 patients(13.64%)in research group had hemadostenosis of AVF and 11 patients(25%)in control group,but there was no statistical significance.Conclusion Puncture with hemodialysis indwelling needle on autogenous arteriovenous fistula at initial stages can maintain high one-time success rate of puncture,reduce hematoma occuring during hemodialysis,increase patient comfort level,maintain AVF flow,alleviate vessel injury and may reduce the occuring of complication such as hemadostenosis.