盐酸丁卡因胶浆缓解维持性血液透析患者内瘘穿刺疼痛的效果

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摘要目的：探讨盐酸丁卡因胶浆缓解维持性血液透析（MHD）患者内瘘穿刺疼痛的效果。方法：将80例使用内瘘穿刺的MHD患者分成2组，对照组40例为常规穿刺，观察组40例为涂用盐酸丁卡因胶浆再行穿刺。采用数字等级评定量表（NRS）和Wong-Baker面部表情量表评分法（FPS-R）记录2组的评分结果，发放患者满意度调查表，对2组患者的穿刺疼痛程度及满意度进行观察和比较。另随机抽取20例患者在同一周内连续2次透析，第1次采用对照组方法进行穿刺，第2次采用观察组方法进行穿刺，观察各组内穿刺前后所测血压及穿刺前后血压波动情况。结果：2组患者观察组疼痛程度明显低于对照组，差异有统计学意义（P＜0.05）；观察组满意度明显高于对照组，差异有统计学意义（P＜0.05）；20例进行血压监测的患者，观察组穿刺前后2次收缩压、舒张压差异均无统计学意义（P＞0.05），对照组穿刺前后2次收缩压、舒张压差异均有统计学意义（P＜0.05）；2组间穿刺前后的血压波动差异有统计学意义（P＜0.05）。结论：盐酸丁卡因胶浆能明显缓解MHD患者内瘘穿刺疼痛，提高患者满意度，减少穿刺前后的血压波动，患者情绪平稳舒适，提高透析依从性。

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	吴瑶瑶
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	徐武敏

关键词 ：血液透析, 盐酸丁卡因胶浆, 内瘘穿刺, 缓解, 疼痛

Abstract：Objective: To explore the effect of tetracaine hydrochloride mucilage on the relief of pain in maintenance hemodialysis patients. Methods: Totally 80 hemodialysis patients using fistula were divided into two groups equally: puncture group as control and tetracaine hydrochloride mucilage group as experiment group. Numerical rating scale and Faces rating scales were used to record the pain scores. Satisfaction questionnaire was handed out to the patients and the data from those two groups were compared. Another 20 hemodialysis patients with two successive dialysis session were recruited. In these patients, routine puncture was performed initially, and then tetracaine hydrochloride mucilage was applied to the fistule for the next successive hemodialysis session. Blood pressure before and after the puncture at different times were compared. Results: Pain scale was significantly lower in the experiment group (P<0.05) while the satisfaction rate was higher compared with the control group. There were differences in systolic and diastolic pressure in 20 patients for the first time using routine puncture respectively (P<0.05). However, the difference in blood pressure was not significant in the 20 patients for the next dialysis session (P>0.05). The systolic and diastolic pressure before and after puncture showed significant difference for the first and second time of hemodialysis session respectively in 20 hemodialysis patients. Conclusion: The use of tetracaine hydrochloride mucilage could relieve pain, increase the satisfaction rate and decrease the fluctuation of blood pressure, thus alleviating anxiety and promoting the patients’ compliance to the treatment of hemodialysis.

Key words： hemodialysis tetracaine hydrochloride mucilage fistula puncture relief pain

收稿日期: 2018-01-23

通讯作者: 徐武敏，副主任护师，Email：1445019709@qq.com。

作者简介: 吴瑶瑶（1979-），女，浙江温州人，主管护师。

链接本文:

https://xb.wmu.edu.cn/CN/ 或 https://xb.wmu.edu.cn/CN/Y2018/V48/I10/776

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