This study conducted a bibliometric analysis of the literature related to the field of hemodialysis arteriovenous fistula from the Web of Science database. The current and future research hotspots and development trends in this field were visualized by sorting and interpreting the research data and drawing a visualization chart. This study suggests that there are certain academic barriers between China and developed countries, and international multicenter clinical trials should be conducted in the future with early identification of arteriovenous fistula dysfunction and emerging diagnostic tools as the academic development direction.

article: Effects of nursing intervention based on feedforward control on preventing unplanned interruption during continuous renal replacement therapy - Minerva Surgery 2022 Jun 16 - Minerva Medica - Journals

Objective: To assess impact of nursing activity group model on health education of patients with drugs. Methods: This study is a retrospective study, that we collected the data before and after the establishment of the nursing action group, and evaluated the effect of establishing the nursing action group by comparing the data. We performed this study in a general tertiary hospital from January 2019 to December 2020. There were 2 stages in the study. At stage 1 (January 2019 - December 2019), we carried out common nursing model in daily work. At stage 2 (July 2020 - December 2020), we implemented usual measures and the countermeasures of nursing activity group themed at improving health education of drug. Using the assessment of medication compliance, satisfaction of patient and drug cognition of patients, we compared the changes of patients’ health education before and after the interventions to evaluate the effect of nursing activity group model. Result: Most of assessments were significant difference between two group, that health education of gastroenterology drugs of nurse and training on drug using on nurses had significant improvement after carry out nursing activity group model. In patients’ assessment of medication compliance and satisfaction, there was only a small increase in patient satisfaction by carrying out nursing activity group model, but patients were observed to be improved significantly during carrying out nursing activity group. Conclusion: Nursing activity group model can improve medication compliance of patients, satisfaction of patients, and drug cognition of nurses.

Objective: To assess effect of cognitive behavioral nursing on quality of life in hemodialysis patients. Methods: We invite 120 patients to join our study from January 2018 to January 2020. They were diagnosed as chronic renal failure in the hospital. In addition, the patients receive hemodialysis treatment in treatment process. In study beginning step, the participants were randomly assigned to a control group (n=60) and intervention group (n=60). For participants of control group, the patients receive the common nursing intervention in hemodialysis process. Additionally, the intervention group patients receive cognitive behavioral nursing on the basis of routine nursing. Result: In depression assessment and anxiety assessment, the control group and intervention group have similar assessment in depression status and anxiety status. In after nursing intervention part, the two groups have different assessment in research result. In health literacy assessment, the two group patients improve their health literacy in four elements. In addition, intervention group has better improvement that that of control group. In addition, the research result of coping style assessment and quality of life assessment are similar, that the two groups have different improvement in research result, that intervention group has better improvement than that of control group. Conclusion: the cognitive behavioral nursing improves some aspects of chronic renal failure patients, that include mental health, health literacy of patient, coping style level of patient and quality of life.

Objective: To assess the Effect of dietary nursing intervention on nutritional status of diabetes and kidney disease patients who are treated by hemodialysis. Methods: 80 patients who are diagnosed as diabetes or kidney disease and are treated by hemodialysis are invited to join our study. all participants were randomly assigned to two groups. In control group, the participants receive the common nursing intervention service. In intervention group, expect of common nursing intervention service, we provide additional dietary nursing intervention service. We record some index of participants that include water electrolyte index, nutritional status indicator, blood glucose levels and renal function index. Additionally, we use World Health Organization Quality of Life Brief Version (WHOQOL-BREF) to collect quality of life assessment. Result: In water electrolyte index research, the intervention group has lower index that that of control group in blood calcium, blood phosphorus and blood potassium. In assessment of nutritional status, intervention group participants have better performance than that of control group. In the assessment of blood glucose levels and renal function, intervention group participants have better blood glucose levels and renal function than that of control group. In quality of life assessment, the quality of life of the intervention group was significantly higher than that of the control group (p ≤ 0.05). Conclusion: the dietary nursing intervention can effectively improve some physiological aspects during the maintenance hemodialysis treatment of patients with diabetic nephropathy, that include: correct the disorder of water and electrolyte, reduce the risk of malnutrition, control blood sugar, improve renal function and improve the quality of life.

Objective: To assess the effect of personalized nursing on thrombolytic hemodialysis patients after arteriovenous fistula occlusion. Methods: 92 patients who undergoing arteriovenous fistula in the hospital were invited to join our study. The time of they receive the treatment is from May 2015 to July 2020. In study beginning, the patients were randomly assigned to the control group (n = 46) and an intervention group (n = 46). The two groups receive different nursing intervention. The control group receive common nursing intervention. On the other hand, the intervention group patients receive personalized nursing intervention in treatment process. Result: In basic patient information, the patient basic status are similar [20 (47.6%) vs 23 (54.8%), 38.14±9.12 vs 37.88±10.07, 1.41±0.75 vs 1.37±0.69], that the gender, age and number of thrombolysis are not statistical significance (p > 0.05). In thrombolysis success rate research, the intervention group has higher thrombolysis success rate than that of control group [38 (90.5%) vs 32 (76.2%), p = 0.016]. In patient satisfaction research result, more intervention group patients make very well assessment than that of control group patients [19 (45.2%) vs 10 (23.8%), p < 0.005]. Conclusion: the personalized nursing intervention not only increase thrombolysis success rate but also improve the patient satisfaction in arteriovenous fistula occlusion.

目的 探讨自体大隐静脉上肢移植内瘘的临床应用及护理.方法 选择2012年8月 -2013年4月在某院血液净化中心维持性血液透析的患者10例.这些患者的吻合动脉为上肢肱动脉或桡动脉 ,静脉采用肘正中静脉、头静脉或贵要静脉 ;J形或U 形搭桥术式端侧吻合.术后给予专科护理 ,专人开瘘 ,实行首次穿刺负责制.定期评估移植内瘘的通畅情况 ,通过血生化计算透析充分性.结果 10例患者移植后即刻通畅率为100% ,术后未见感染、血肿等并发症.3例患者因各种原因终止使用 ;其余7例均正常使用至今 ,最长的已使用32个月 ,血透时血泵流速达到200~250 mL/min.每季度抽查血生化显示Kt/V均达标.结论 大隐静脉移植上肢内瘘长期通畅率高 ,并发症少 ,易于穿刺 ,血流充足 ,透析充分性好 ,可作为血液透析患者有效的血管通路之一.

维持性血液透析（ MHD）患者妊娠合并症和并发症多，成功妊娠者少［1］。我科2012年收治2例MHD 3年以上合并妊娠患者，根据患者妊娠晚期生理的特性，给予个体化的血液净化治疗方案和精心、细致的护理，最终成功分娩。随访至今2位婴幼儿生长发育正常。现将我们的临床护理报告如下。

目的:应用JH血液透析机的多功能性行PE、HP和CRRT治疗,并与进口血液透治疗进行比较,以探讨危重患者救治措施及方案选择.方法:102例患有ARF、SIRS、MODS、SAP、ARDS等危重症患者,根据治疗方式的不同分为:CAVHD(A组);CAVHF或CAVHDF(B组);及CAVHF或CAVHDF配合PE或HP治疗(C组).对照组为条件相当的重症患者行HD治疗.结果:A、B、C 3组及对照组治疗前后自身对照结果显示血清BUN、Cr、K+和PO43-均有明显降低(P＜0.001),血清CO2CP显著升高(P＜0.01);各组治疗前后Cr和BUN下降幅度比较无显著性差异,与对照组相比差异均有显著性(P＜0.05).CK、ALT、AST、LDH、和D-二聚体治疗前后比较在B组和C组均有显著降低(P＜0.01;P＜0.001),且C组患者CIC、CK、LDH、和D-二聚体的下降幅度较B组差异有显著性(P＜0.05).各治疗组显效率和总有效率明显高于对照组,而死亡率和总无效率明显低于对照组.临床观察到,JH血液净化仪血流量和透析液流量稳定,监控精确,精确度和灵敏度很高,性能稳定,治疗过程中均未发现仪器相关的不良反应.结论:通过CRRT持续恒定地清除中小分子毒素、纠正水电解质酸碱平衡紊乱,并对于危重患者联合PE和HP可清除大分子毒素,可为临床危重患者抢救提供更多的手段和措施.

Objective To observe the clinical efficacy of treatment combining continuous renal replacement therapy(CRRT) with plasma exchange(PE) in critically ill patients and do comparison with hemodialysis or hemodiafiltration.Methods A total of 60 critically ill patients were divided into observation group and comparison group.Then the biochemical markers and clinical efficacy were observed.Results After treatment,serum BUN,Cr,and K+ in the two groups were significantly decreased(P<0.01);After combining CRRT with PE treatment,CIC,CK,ALT,AST,LDH,and D-Di were significantly lower(P<0.01),and the decrease range was significantly higher than that in comparison group(P<0.05).Conclusion Combined with PE,it can remove big molecule toxins by CRRT continuously and constantly removing small molecule toxins,correcting acid-base balance of water electrolyte disorders for critically ill patients,which can provide more tools and measures for clinical patients in an emergency.

目的探讨JH血液透析机(广州暨华公司)血液净化治疗危重症患者的疗效。方法治疗组采用JH血液透析机对102例危重症患者分别行血液透析(HD)(A组)、血液滤过(HF)(B组)、HF配合血浆置换(PE)或血液灌流(HP)(C组)治疗。对照组为条件相当的31例重症患者,采用进口设备行HF治疗。结果各治疗组尿毒症毒素均降低(P<0.05),但与对照组比较差异均无统计学意义(P>0.05)。B、C组和对照组治疗后肌酸激酶(CK)、ALT、AST、乳酸脱氢酶(LDH)和D-二聚体均较治疗前降低(P<0.05)。C组循环免疫复合物(CIC)治疗后较治疗前降低(P<0.05)。结论 JH血液净化仪除可行HD治疗外,设备还可推移到床边行持续性HF治疗,有利于基层单位开展多种血液净化治疗项目。

目的探讨各种血液净化技术在低龄患儿中的应用。方法对5例出生后3d～7岁患儿因原发病不同采用不同的血液净化治疗,使用对应的机型、血液净化材料、抗凝方式及血管通路。结果5例患儿的血液净化治疗均能顺利进行,4例痊愈,1例因血管通路问题转为腹膜透析。结论了解小儿的生理特点,选择合适的材料,建立有效的血管通路,严密调节各种参数和监护,低龄小儿血液净化可以顺利进行。

目的观察可调钠低温透析对透析低血压的影响。方法22例患者采用自身前后对照方法,随机进行可调钠低温透析和普通钠常温透析,各治疗3个月。每1个月查1次透析前后血生化。结果可调钠低温组低血压的发生率明显低于普通钠组(2χ=29.52,P<0.01),2组透析前后钠离子浓度无明显变化,透析后血钾、肌酐、尿素氮浓度明显下降(P<0.01)。结论可调钠低温透析能较好地预防透析低血压的发生,不增加患者的钠负荷,不影响透析效果,值得推广应用。

透析低血压是血液透析中最常见的并发症之一,发生率可达20%～30%[1].透析低血压的一个重要原因是过多脱水导致的血容量显著下降,血容量下降超过15%时极易发生低血压,而与总体液量下降无关[2].2002年2月-2004年12月,本研究对21例在我科血液净化中心维持性血液透析常发生透析低血压的患者,在透析时使用钠泵400次,以有效地预防低血压的发生,透析1个月后检查透析前后血生化指标,显示血钠浓度变化不明显,现报道如下。

目的探讨维持性血液透析患者应用人造血管内瘘的护理。方法对12例人造血管内瘘患者的护理进行回顾性总结。结果12例人造血管造瘘术后血管通畅率为100%,2例发生感染,1例发生内瘘堵塞,1例血栓形成。结论做好造瘘前后患者及家属的心理护理,正确掌握人造血管内瘘的穿刺方法,预防感染和血栓形成,加强健康教育对于延长人造血管内瘘的使用寿命,提高患者生活质量非常重要。