The application of improved blunt needle buttonhole method in fistula puncture of hemodialysis

Abstract

Objective To learn the impact of blunt needle puncture and improved buttonhole blunt needle puncture on maintenance hemodialysis patients.Methods Ninety hemodialysis patients with arteriovenous fistula as vascular access were randomly assigned to group A (n =30,ordinary puncture),B (n =30,blunt needle puncture) and C (n =30,improved blunt needle puncture).Puncture related complications,biochemical markers and dialysis adequacy of the patients were compared after 6 months.Multivariate Cox regression was used for data analysis.Results The incidence of puncture site pain and fistula stenosis of the group C was lower than that of the group A and B,and the incidence of fistula hematoma and pseudoaneurysm was lower than group A (P ＜0.05).In group C,CRP level of the patients was lower than group A and B,although HGB level was higher than the other two groups after six months (P ＜ 0.05).In Cox multivariate regression,the main factors of fistula puncture complications were dialysis age,HGB and CRP.Conclusions The improved grommets blunt needle puncture method can significantly reduce the incidence of dialysis puncture site hematoma,pseudoanemysm and stenosis,and reduce microinflammation of dialysis patients.Fistula puncture comphcations may be associated with dialysis age,HGB and CRP level. Key words: Hemodialysis; Improved grommets blunt needle puncture; Arteriovenous fistula