Exploration of a new model for integrated medical and nursing follow-up management of vascular access for patients with hemodialysis during hospitalization and outpatient period_West China Medical Journal

Authors：

WANG Jing ¹ , ZENG Ying ¹ , ZHU Linfang ¹ , YU Shaobin ² ,  YUAN Huaihong ¹

1. Department of Nephrology, West China Hospital, Sichuan University / West China School of Nursing, Sichuan University, Chengdu, Sichuan 610041, P. R. China;
2. Department of Nephrology, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, P. R. China;

Corresponding author：

YUAN Huaihong, Email: yuanhuaihong@wchscu.cn

Keywords：

Autogenous arteriovenous fistula; integrated medical and nursing management; follow-up management

DOI：

10.7507/1002-0179.202306081

Video：

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At present, the whole lifecycle management of vascular access for hemodialysis in China is still in its early stages. Faced with a large group of chronic kidney disease patients, hospitals at all levels lack systematic and continuous nursing management models. To address the issue of lacking continuous and effective nursing management of vascular access for dialysis during the period from hospitalization for autologous arteriovenous fistula surgery to outpatient maintenance hemodialysis treatment, this article introduces the background, specific implementation methods, and preliminary results of the new model of integrated medical and nursing follow-up management of vascular access for patients with hemodialysis during hospitalization and outpatient period constructed by the Wenjiang Hemodialysis Center of West China Hospital, Sichuan University. The purpose is to explore a new model for continuous and effective management of vascular access for hemodialysis patients.

Citation： WANG Jing, ZENG Ying, ZHU Linfang, YU Shaobin, YUAN Huaihong. Exploration of a new model for integrated medical and nursing follow-up management of vascular access for patients with hemodialysis during hospitalization and outpatient period. West China Medical Journal, 2024, 39(3): 490-493. doi: 10.7507/1002-0179.202306081 Copy

1.	Himmelfarb J, Vanholder R, Mehrotra R, et al. The current and future landscape of dialysis. Nat Rev Nephrol, 2020, 16(10): 573-585.
2.	Johansen KL, Chertow GM, Foley RN, et al. US Renal Data System 2020 annual data report: epidemiology of kidney disease in the United States. Am J Kidney Dis, 2021, 77(Suppl 1): A7-A8.
3.	蒋佳维. 中国慢性肾脏病的发病率. 中华危重病急救医学, 2023, 35(7): 718.
4.	Johnson DS, Meyer KB. Delaying and averting dialysis treatment: patient protection or moral hazard?. Am J Kidney Dis, 2018, 72(2): 251-254.
5.	蔡艳菊, 肖惠敏. 生活方式对维持性血液透析患者预后影响的研究进展. 中国血液净化, 2021, 20(2): 115-117.
6.	Hicks CW, Wang P, Kernodle A, et al. Assessment of use of arteriovenous graft vs arteriovenous fistula for first-time permanent hemodialysis access. JAMA Surg, 2019, 154(9): 844-851.
7.	Lok CE, Huber TS, Lee T, et al. KDOQI clinical practice guideline for vascular access: 2019 update. Am J Kidney Dis, 2020, 75(Suppl 2): S1-S164.
8.	Gilmore J. KDOQI clinical practice guidelines and clinical practice recommendations--2006 updates. Nephrol Nurs J, 2006, 33(5): 487-488.
9.	中国医院协会血液净化中心分会血管通路工作组. 中国血液透析用血管通路专家共识(第 2 版). 中国血液净化, 2019, 18(6): 365-381.
10.	王慧, 姚苗苗, 王金环, 等. 关卡前移在血液透析病人动静脉内瘘一体化管理中的应用. 护理研究, 2022, 36(13): 2433-2435.
11.	邱丽蓉, 程冬梅, 钟守英, 等. 功能锻炼配合中药熏洗对自体动静脉内瘘成熟的影响. 中医药导报, 2016, 22(17): 91-93.
12.	邵彩霞, 安淑君, 黑小杰. 手部阻力锻炼对动静脉内瘘成熟的影响及远期使用时限的研究. 护士进修杂志, 2018, 33(19): 1774-1776.
13.	黄少敏, 岑忠耿, 张伟帅, 等. 彩色多普勒超声评估透析患者动静脉内瘘血栓及狭窄的临床价值. 中国超声医学杂志, 2016, 32(1): 31-33.
14.	徐元恺, 张文云, 段青青, 等. 吻合口动脉端狭窄致自体动静脉内瘘早期失功的初步研究. 中国血液净化, 2016, 15(9): 494-497.
15.	鹿香花, 王梦洁. 血液透析患者动静脉内瘘栓塞的预防护理. 护理学杂志, 2016, 31(19): 31-33.
16.	肖祥, 马荣, 皋娅, 等. 不同血管通路血液透析患者的预后分析. 西部医学, 2020, 32(10): 1504-1508.
17.	Chan C, Ochoa CJ, Katz SG. Prognostic factors for arteriovenous fistula maturation. Ann Vasc Surg, 2018, 49: 273-276.
18.	布合力其·麦麦提, 莫颖, 张蕾, 等. 维持性血液透析患者的临床及预后分析. 中国现代医学杂志, 2022, 32(7): 77-83.
19.	Almasri J, Alsawas M, Mainou M, et al. Outcomes of vascular access for hemodialysis: a systematic review and meta-analysis. J Vasc Surg, 2016, 64(1): 236-243.
20.	Arhuidese IJ, Cooper MA, Rizwan M, et al. Vascular access for hemodialysis in the elderly. J Vasc Surg, 2019, 69(2): 517-525.e1.
21.	张瑶, 张春秀, 吴德芳, 等. 云平台在永久性血管通路手术患者护理中的应用. 中华护理教育, 2019, 16(4): 273-276.
22.	王钦, 谢勇, 余少斌. 超声稀释法在带隧道带涤纶套导管患者中的临床应用. 临床肾脏病杂志, 2019, 19(9): 668-671.

1. Himmelfarb J, Vanholder R, Mehrotra R, et al. The current and future landscape of dialysis. Nat Rev Nephrol, 2020, 16(10): 573-585.
2. Johansen KL, Chertow GM, Foley RN, et al. US Renal Data System 2020 annual data report: epidemiology of kidney disease in the United States. Am J Kidney Dis, 2021, 77(Suppl 1): A7-A8.
3. 蒋佳维. 中国慢性肾脏病的发病率. 中华危重病急救医学, 2023, 35(7): 718.
4. Johnson DS, Meyer KB. Delaying and averting dialysis treatment: patient protection or moral hazard?. Am J Kidney Dis, 2018, 72(2): 251-254.
5. 蔡艳菊, 肖惠敏. 生活方式对维持性血液透析患者预后影响的研究进展. 中国血液净化, 2021, 20(2): 115-117.
6. Hicks CW, Wang P, Kernodle A, et al. Assessment of use of arteriovenous graft vs arteriovenous fistula for first-time permanent hemodialysis access. JAMA Surg, 2019, 154(9): 844-851.
7. Lok CE, Huber TS, Lee T, et al. KDOQI clinical practice guideline for vascular access: 2019 update. Am J Kidney Dis, 2020, 75(Suppl 2): S1-S164.
8. Gilmore J. KDOQI clinical practice guidelines and clinical practice recommendations--2006 updates. Nephrol Nurs J, 2006, 33(5): 487-488.
9. 中国医院协会血液净化中心分会血管通路工作组. 中国血液透析用血管通路专家共识(第 2 版). 中国血液净化, 2019, 18(6): 365-381.
10. 王慧, 姚苗苗, 王金环, 等. 关卡前移在血液透析病人动静脉内瘘一体化管理中的应用. 护理研究, 2022, 36(13): 2433-2435.
11. 邱丽蓉, 程冬梅, 钟守英, 等. 功能锻炼配合中药熏洗对自体动静脉内瘘成熟的影响. 中医药导报, 2016, 22(17): 91-93.
12. 邵彩霞, 安淑君, 黑小杰. 手部阻力锻炼对动静脉内瘘成熟的影响及远期使用时限的研究. 护士进修杂志, 2018, 33(19): 1774-1776.
13. 黄少敏, 岑忠耿, 张伟帅, 等. 彩色多普勒超声评估透析患者动静脉内瘘血栓及狭窄的临床价值. 中国超声医学杂志, 2016, 32(1): 31-33.
14. 徐元恺, 张文云, 段青青, 等. 吻合口动脉端狭窄致自体动静脉内瘘早期失功的初步研究. 中国血液净化, 2016, 15(9): 494-497.
15. 鹿香花, 王梦洁. 血液透析患者动静脉内瘘栓塞的预防护理. 护理学杂志, 2016, 31(19): 31-33.
16. 肖祥, 马荣, 皋娅, 等. 不同血管通路血液透析患者的预后分析. 西部医学, 2020, 32(10): 1504-1508.
17. Chan C, Ochoa CJ, Katz SG. Prognostic factors for arteriovenous fistula maturation. Ann Vasc Surg, 2018, 49: 273-276.
18. 布合力其·麦麦提, 莫颖, 张蕾, 等. 维持性血液透析患者的临床及预后分析. 中国现代医学杂志, 2022, 32(7): 77-83.
19. Almasri J, Alsawas M, Mainou M, et al. Outcomes of vascular access for hemodialysis: a systematic review and meta-analysis. J Vasc Surg, 2016, 64(1): 236-243.
20. Arhuidese IJ, Cooper MA, Rizwan M, et al. Vascular access for hemodialysis in the elderly. J Vasc Surg, 2019, 69(2): 517-525.e1.
21. 张瑶, 张春秀, 吴德芳, 等. 云平台在永久性血管通路手术患者护理中的应用. 中华护理教育, 2019, 16(4): 273-276.
22. 王钦, 谢勇, 余少斌. 超声稀释法在带隧道带涤纶套导管患者中的临床应用. 临床肾脏病杂志, 2019, 19(9): 668-671.

West China Medical Journal

Exploration of a new model for integrated medical and nursing follow-up management of vascular access for patients with hemodialysis during hospitalization and outpatient period

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