血液透析患者动静脉内瘘的护理策略研究

摘    要
本文综述了动静脉内瘘在血液透析患者中的基础概述、生理机制、常见并发症及护理难点与策略。动静脉内瘘作为血液透析的关键血管通路，其定义为动脉与静脉之间的异常连接，常通过手术方式建立，旨在提供足够的血流量以支持透析治疗。本文详细探讨了动静脉内瘘建立后血流动力学的显著改变及由此引发的血管重塑过程，这些生理机制对于理解内瘘的功能与并发症至关重要。针对血液透析患者，动静脉内瘘的常见并发症包括血栓形成、感染和心力衰竭，这些并发症严重影响患者的生活质量和透析效果。其中，血栓形成由血流动力学改变和护理不当等因素引起；感染则与皮肤破损、污染及患者免疫功能低下密切相关；而心力衰竭则可能是由于内瘘导致的血流动力学负荷增加所致。护理方面，本文指出了血液透析患者动静脉内瘘护理的几大难点，包括高感染风险、皮肤破损与污染、免疫功能低下、血栓形成风险大、护理依从性低以及并发症多样。为应对这些挑战，本文提出了相应的护理策略，包括加强无菌操作、及时处理皮肤破损、增强患者免疫力、减少血液黏稠度、提高患者自我护理能力以及定期监测并发症等，旨在降低并发症发生率，提高患者透析效果和生活质量。

关键词：血液透析；动静脉内瘘；护理策略

Abstract
This review summarizes the basic overview, physiological mechanisms, common complications, and nursing difficulties and strategies of arteriovenous fistula in hemodialysis patients. As a key vascular access route for hemodialysis, arteriovenous fistula is defined as an abnormal connection between artery and vein and is often established by surgical means, designed to provide sufficient blood flow to support dialysis treatment. This paper explores in detail the significant changes in hemodynamics after the establishment of the arteriovenous fistula, and these physiological mechanisms are crucial for understanding the function and complications of the fistula. For hemodialysis patients, common complications of arteriovenous fistula include thrombosis, infection and heart failure, which seriously affect the quality of life and dialysis effectiveness. Among them, thrombosis is caused by hemodynamic changes and improper care; infection is closely related to skin damage, contamination and patient immune deficiency; and heart failure may be caused by increased hemodynamic load caused by internal fistula. In terms of nursing, this paper points out several difficulties in the care of arteriovenous fistula in hemodialysis patients, including high risk of infection, skin damage and contamination, immunodeficiency, high risk of thrombosis, low compliance with nursing, and various complications. In order to meet these challenges, this paper puts forward the corresponding nursing strategies, including strengthening aseptic operation, timely treatment of skin damage, enhance patient immunity, reduce blood viscosity, improve patient self-care ability and regular monitoring of complications, aims to reduce the incidence of complications, improve the dialysis effect and quality of life.

Key  words:  Hemodialysis; arteriovenous fistula; nursing strategy

目    录
中文摘要 I
英文摘要 II
目    录 III
引    言 1
第1章、动静脉内瘘基础概述 1
1.1、动静脉内瘘的定义 1
1.2、动静脉内瘘的手术方式 1
第2章、血液透析患者动静脉内瘘的并发症 1
2.1、血栓形成 1
2.2、感染 1
2.3、心力衰竭 1
第3章、血液透析患者动静脉内瘘的护理难点 1
3.1、感染风险高 1
3.2、血栓形成风险大 1
3.3、护理依从性低 2
3.4、并发症多样 2
第4章、血液透析患者动静脉内瘘的护理策略 3
4.1、加强无菌操作 3
4.2、减少血液黏稠度 3
4.3、提高自我护理能力 4
4.4、定期监测并发症 4
结    论 5
参考文献 6