移植物动静脉内瘘链式管理方案的构建及应用研究

doi:10.3761/j.issn.1672-9234.2025.03.017

摘要/Abstract

摘要：

目的构建移植物动静脉内瘘（arteriovenous graft，AVG）链式管理方案，并探讨其临床实践效果。方法通过文献回顾、专家咨询法，构建AVG链式管理方案。选取2021年1月1日—2022年12月31日于该院接受AVG成形术的终末期肾病患者为研究对象，根据患者是否愿意接受AVG链式管理，将其分入试验组或对照组，对试验组实施以血管通路护理骨干为主导的AVG链式管理方案，给予对照组常规护理。比较两组AVG启用后1年内的一期辅助通畅时间、二期通畅时间，进入通路随访期后1年内的诊室随访率，以及AVG启用后1年内的多单穿刺执行率。结果共纳入符合标准的患者204例，其中试验组123例、对照组81例。试验组、对照组AVG启用后1年内的一期辅助通畅时间依次为12.0（8.6，12.0）个月、10.0（6.8，10.0）个月（Log-rank检验χ²=5.870、P=0.015），二期通畅时间依次为12.0（9.2， 12.0）个月、12.0（8.4，12.0）个月（Log-rank检验χ²=8.343，P=0.004）。试验组进入通路随访期后1年内的诊室随访率，以及AVG启用后1年内的多单穿刺执行率均高于对照组（P<0.05）。结论 AVG链式管理方案的实施有利于延长终末期肾病患者AVG的通畅时间，提升患者诊室随访依从性，提高多单穿刺执行率。

关键词: 链式管理, 移植物动静脉内瘘, 随访依从性, 通畅率

Abstract:

Objective To develop a chained management protocol for arteriovenous graft（AVG） and explore its effects in clinical practice. Methods An AVG chained management protocol was constructed through literature review and expert consultation. End-stage renal disease patients who had underwent AVG angioplasty in a hospital from January 1，2021，to December 31，2022，were recruited as study participants. Based on their willingness to receive AVG chained management，patients were divided into an experimental group or a control group. The experimental group received an AVG chained management protocol，while the control group received routine care. The primary and secondary patency times within one year after AVG cannulation，the clinic follow-up rate within one year after entering the access follow-up period，and the multi-single puncture execution rate within one year after AVG cannulation were collected and compared between the two groups. Results A total of 204 eligible patients were included，with 123 in the experimental group and 81 in the control group. The median primary patency time within one year after AVG cannulation was 12.0（8.6，12.0） months in the experimental group and 10.0 （6.8，10.0） months in the control group（χ²=5.870，P=0.015）. The median secondary patency time was 12.0 （9.2，12.0） months and 12.0（8.4，12.0） months in experimental group and control group，respectively（χ²=8.343，P=0.004）. The clinic follow-up rate within one year after entering the access follow-up period and the multi-single puncture execution rate within one year after AVG cannulation were higher in the experimental group than that in the control group（P<0.05）. Conclusion The implementation of the AVG chained management protocol is beneficial for prolonging AVG patency time in end-stage renal disease patients，improving patient adherence to clinic follow-up，and increasing the multi-single puncture execution rate.

Key words: Chain management, Arteriovenous graft, Follow-up compliance, Patency

薛小玲, 岳晓红, 邓亚楠, 王炎, 徐甜甜, 王瑞敏, 王沛. 移植物动静脉内瘘链式管理方案的构建及应用研究[J]. 中华护理教育, 2025, 22(3): 363-370.

XUE Xiaoling, YUE Xiaohong, DENG Ya’nan, WANG Yan, XU Tiantian, WANG Ruimin, WANG Pei. Development and application of a chain management protocol for arteriovenous graft[J]. Chinese Journal of Nursing Education, 2025, 22(3): 363-370.

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