天津中医药大学第一附属医院 国家中医针灸临床医学研究中心 肾病科血透中心, 天津, 300381
收稿:2025-06-15,
修回:2025-09-09,
录用:2025-09-10,
网络出版:2025-11-25,
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张雯, 张家贝. 1例动静脉内瘘穿刺失败后的连续护理[DB/OL].中西医结合临床案例库, 2025.
ZHANG Wen, ZHANG Jiabei. Continuous Nursing Care After Arteriovenous Fistula Puncture Failure: A Case Report[DB/OL].Clinical Archives of Integrative Medicine, 2025.
张雯, 张家贝. 1例动静脉内瘘穿刺失败后的连续护理[DB/OL].中西医结合临床案例库, 2025. DOI: 10.12209/CAIM202506150009.
ZHANG Wen, ZHANG Jiabei. Continuous Nursing Care After Arteriovenous Fistula Puncture Failure: A Case Report[DB/OL].Clinical Archives of Integrative Medicine, 2025. DOI: 10.12209/CAIM202506150009.
本文总结1例维持性血液透析动静脉内瘘穿刺失败后的中西医结合护理经验。基于血透专科护理应急处理基础上,结合专科监测皮温臂围、复查D-二聚体、血管彩超、血管外科黄连消肿膏湿敷联合治疗干预,有效减轻患者手臂肿胀,减轻心理压力。新置血透长期导管,门诊进行规律透析,待内瘘完全符合穿刺条件,重新评估后再使用内瘘。
This article summarizes the integrated traditional Chinese and Western medicine nursing approach for a maintenance hemodialysis patient following arteriovenous fistula puncture failure. Based on specialized hemodialysis emergency protocols, comprehensive interventions were implemented, including monitoring skin temperature and arm circumference, rechecking D-dimer levels, vascular ultrasound, and external application of Huanglian Xiaozhong Ointment (a traditional Chinese herbal preparation for swelling reduction) in collaboration with vascular surgery. These measures effectively alleviated arm swelling and psychological distress. A new long-term hemodialysis catheter was placed for outpatient dialysis sessions until the fistula fully met puncture criteria upon reevaluation.
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