Effect of modified internal fistula puncture method in treatment of patients with intractable arteriovenous fistula

Objective To explore the application effect of modified internal fistula puncture method in the treatment of patients with intractable arteriovenous fistula.

Methods From June 2020 to June 2022, 80 intractable autologous fistula patients with hemodialysis in the Jiangsu Provincial People's Hospital were randomly divided into control group and trial group, with 40 cases in each group. Conventional puncture methodwas used in the control group, and modified internal fistula puncture method was used in the trial group. The puncture effect, incidence of complications and satisfaction degree were compared between the two groups.

Results After 10 and 40 times of puncture, the intima wall thickness of the internal fistula vessels increased significantly when compared to that before puncture in both groups, and the intima wall thickness of the internal fistula vessels in the control group after 40 times of puncture was significantly greater than that in the trial group (P < 0.05). The success rate of puncture by one time in the trial group was 99.21%, which was significantly higher than 95.62% in the control group (P < 0.05); the score of pain in the trial group was (1.60±0.52), which was significantly lower than (2.40±0.97) in the control group (P < 0.05). The incidence of hematoma in the trial group was 0.04%, which was significantly lower than 1.90% in the control group (P < 0.05); the incidence of blood leakage at the puncture site in the trial group was 0.93%, which showed no significant difference when compared to 1.46% in the control group (P > 0.05). The total incidence of complications in the trial group was significantly lower than that in the control group (P < 0.05); the score of patient's satisfaction degree in the trial group was significantly higher than that in the control group (P < 0.05).

Conclusion Modified internal fistula puncture method can alleviate the pain of vascular puncture in patients with intractable arteriovenous fistula, reduce the incidence of hematoma or blood leakage, reduce the occurrence of complications, and protect the internal fistula vessels.