扣眼式穿刺法在血液透析病人的運用

The Applications of Buttonhole Cannulation in Hemodialysis Patients

蔡明松(Min-Sung Tsai) ； 林孟德(Meng-Te Lin) ； 姜林文祺(Wen-Chi Chiang Lin) ； 施得恩(Te-En Shih)

《腎臟與透析》 28卷4期 (2016/12) Pp. 168-173

https://doi.org/10.6340/KD.2016.28(4).04

摘要

動靜脈廔管是透析患者血液通路的首選，但病患最大考慮在於血管通路是否能提供較少的併發症，美觀而且無痛。扣眼式打法使用鈍針且固定點來上針，打破以往需要每次更改下針處的思維。但陸續許多的研究報告提出它會增加局部及全身感染機會。一時之間使大家卻步。但要提醒的是本技術很需要嚴格遵行無菌與標準技術規範，如同腹膜透析一般也會帶入腹膜炎，甚至也有菌血症。如何選擇合適的病患來施行此技術是醫護人員一個重要的議題。

關鍵字

動靜脈廔管 ； 扣眼式穿刺 ； 繩梯式穿刺 ； 血液透析 ； 感染

並列摘要

Arteriovenous fistulae is the major access of choice for hemodialysis patients. Patients concern the access to be of less pain, no disfigurement and less complications. Buttonhole cannulation uses the dull needle and constant site, which had break the traditional mode of thinking to change the puncture site in each session of dialysis. However, the following reports disclosed that the buttonhole cannulation increasing the infectious risk in local and systemic infections. These adverse reports held back the patients who are intended. Patients and units should be aware that BH is an extremely demanding technique and requires fixed and effective adherence to the protocol. Just like peritoneal dialysis, peritonitis may happen within a period, including exit site infection and systemic bacteremia. It should be an important issue to select patients who suitable for this procedure.

並列關鍵字

arteriovenous fistula ； buttonhole cannulation ； rope ladder cannulation ； hemodialysis ； infection