血液透析室护士超声引导下穿刺自体动静脉内瘘的质性研究

A Qualitative Study on Ultrasound-Guided Puncture of Native Arteriovenous Fistulas by Hemodialysis Nurses

摘要: 目的：探讨血液透析室护士在对维持性血液透析患者进行超声引导下自体动静脉内瘘穿刺的真实经历和体验，为该技术推广提供参考依据。方法：通过对10名血液透析室护士进行半结构式访谈，采用内容分析法整理与分析访谈资料。结果：最终提炼出2个促进因素：可视化提升精准度与安全性，可通过多种学习途径及方法获得；3个障碍因素：超声引导下AVF穿刺技术的实操资源受限，技术门槛较高，时间成本较大。结论：超声引导下穿刺技术可有效提高AVF穿刺的精准度，提升患者安全，建议医院购置必要的超声设备，以提高技术的可及性。在开展该技术前对血液透析室护士进行结构化和系统化的培训以促进该技术的推广。

Abstract: Objective: To explore the experiences and perceptions of nurses in hemodialysis unit regarding ultrasound-guided cannulation technique of Autologous Arteriovenous Fistula (AVF) in Maintenance Hemodialysis patients (MHD), which can provide evidence for promoting implementation. Methods: Semi-structured interviews were conducted with ten nurses from hemodialysis units. The interview data were analyzed using content analysis. Results: Two facilitators were identified: enhanced precision and safety through visualization, and accessibility through diverse learning approaches. Three barriers were also extracted: limited access to practical training resources, high technical threshold, and considerable time investment. Conclusions: The ultrasound-guided cannulation technique of AVF significantly enhances procedural accuracy and patient safety. To improve the accessibility and implementation of this technique, healthcare institutions should invest in essential ultrasound equipment and provide structured, systematic training for hemodialysis nurses.