As the lifeline of dialysis patients, arteriovenous fistula is often easily ignored when it is just dialysis, resulting in later complications such as infection, thrombosis, and aneurysm.
For dialysis kidney friends, daily maintenance of internal fistula is particularly important, and the common protection methods of internal fistula will be introduced below, which are worth collecting for kidney friends!
1. Develop the Xi of observing internal fistula every day
Dialysis is required for kidney patientsCheck whether the internal fistula is smooth every day in the morning, at noon, and before going to bedVascular bruits can be heard with the ear or stethoscope;Or touch the blood vessel tremor with your fingers, and if you find that the tremor or mur disappears or weakens, you should contact the attending doctor immediately for treatment.
The clinical manifestations of normal and stenosis of internal fistula maturation can be referred to the following table:
2. Before each dialysis, clean the arm on the side of the fistula
Before each dialysis, be sure to clean the fistula side arm with soap or hand sanitizer.
Especially in summer, the location of the internal fistula is in frequent contact with the outside world, which is easy for bacteria to breed, resulting in internal fistula infection, which affects the dialysis effect.
It should be noted thatOn the day of dialysis, remember not to touch the scab of the needle eye after puncture on the day of dialysis and not to pick the scab of the needle hole with your hand to avoid internal fistula infection. Bathing or swimming should be done with a waterproof tape on the puncture site, preferably the day before the next dialysis.
3. Replace the puncture point reasonably
Whether it is an autologous fistula or an artificial vascular fistula, each puncture is a trauma to the internal fistula.
If the puncture site does not heal completely, a new wound will be accepted after 2-3 days, and over time, complications such as stenosis, thrombosis, infection, neoplasia, and rupture will occur in the blood vessels that have been punctured repeatedly.
The rope ladder puncture method can be selected, so that each puncture site has enough time to recuperate, which can delay the occurrence of complications and prolong the life of the internal fistula.
Fourth, press well after the needle is removed
Do not rush to cause insufficient compression time, compression time according to individual differences at least 10-15 minutes, elastic bandage first tighten and then loosen, after 1 hour without bleeding can be removed, if there is bleeding, continue to compress.
If the tremor weakens or disappears, the depth of compression should be adjusted immediately and continued to be observed, and if the bleeding does not stop, the compression should be continued, and the emergency department should be seen at the same time.
5. Exercise and protect well
One to two weeks after the internal fistula operation, if the wound is not oozing, no infection, and the healing is good, do some fistula exercises, such as:Pinch the rubber ball or rubber band several times with the side of the operation, 3-5 minutes each time, 2-3 times a day.
Daily warm compresses help the fistula mature. Even if an internal fistula has formed after dialysis, it is important to pay attention to daily continuous exercise.
In order to prevent excessive expansion of blood vessels, the wrist brace should not be too tight to avoid unnecessary damage to the internal fistula.
6. Ensure nutrition
Mainly low-salt, low-fat, high-quality protein foods, appropriate supplementation of water-soluble vitamins, limit fluid intake, reduce the intake of high-potassium foods and phosphorus-containing additive foods, and avoid long-term high calcium caused by vascular calcification.
In short, hemodialysis patients should cultivate and strengthen the self-monitoring and daily maintenance of autologous arteriovenous fistula to improve their cognition.
If you can proactively protect it, you can prolong the use of internal fistula, reduce the occurrence of complications, and contact the attending doctor in time if the problem is found.