目的 探讨肌内效贴治疗血液透析患者动静脉内瘘血管穿刺后血肿的有效性。 方法 选取首都医科大学附属北京积水潭医院肾内科血液净化中心2022年1月─2024年3月收治的34例动静脉内瘘血管穿刺后血肿患者，按照随机数字表法分为对照组和试验组，分别给予多磺酸粘多糖软膏涂抹联合热敷或肌内效贴贴扎治疗，对比2组视觉模拟疼痛评分(visual analog scale,VAS)、血肿硬度、皮肤瘀斑消退时间以及治疗效果等指标。 结果 治疗3天、6天、9天后，2组VAS均逐步降低，且治疗3天后(t=3.084，P =0.004)与治疗6天后(Z=-3.536，P＜0.001)试验组VAS均低于对照组。治疗3天、6天、9天后，两组血肿硬度均逐步改善，且治疗3天后试验组的血肿硬度低于对照组(χ2=6.769，P=0.035)。试验组的皮肤瘀斑消退时间短于对照组(t=8.161，P＜0.001)。治疗3天，试验组的治疗有效率达100%(16/16例)，优于对照组的72.22%(13/18例，χ2=5.211，P=0.046)。 结论 肌内效贴应用于血液透析患者动静脉内瘘血管穿刺后血肿的治疗，可减轻疼痛程度，改善血肿硬度，缩短皮肤瘀斑消退时间，促进血肿消退，提高治疗效果。
Objective To investigate the effectiveness of kinesiology tape in the treatment of hematoma after arteriovenous fistula (AVF) puncture in hemodialysis patients. Methods A total of 34 patients with hematoma after AVF puncture admitted to the Blood Purification Center of Department of Nephrology, Beijing Jishuitan Hospital, Capital Medical University from January 2022 to March 2024 were included in this study. They were divided into control group and experiment group according to the random number table method. Mucopolysaccharide polysulfate cream combine with hot compress were used in control group, and kinesiology tape was used in experiment group. Visual analog scale (VAS), hardness of the hematoma, fading time of the skin ecchymosis, and the therapeutic effect were compared between two groups. Results VAS gradually decreased after 3, 6 and 9 days of the treatment in both groups. VAS was significantly lower in experiment group than in control group after 3 days of the treatment (t=3.084, P=0.004) and 6 days of the treatment (Z= -3.536, P＜0.001). Hardness of the hematoma decreased gradually after 3, 6 and 9 days of the treatment in both groups. Hardness of the hematoma was lower in experiment group than in control group after 3 days of treatment (χ2=6.769, P=0.035). Fading time of the skin ecchymosis was significantly shorter in experiment group than in control group (t=8.161, P＜0.001). After 3 days of treatment, the therapeutic effect was better in experiment group (100%, 16/16) than in control group (72.22%, 13/18; χ2=5.211, P=0.046). Conclusion The application of kinesiology tape for the treatment of hematoma after AVF puncture in hemodialysis patients can reduce pain degree and hardness of the hematoma, shorten subsiding time of the skin ecchymosis and hematoma, and improve the therapeutic effect.
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