Prevention of thrombosis in arteriovenous fistula and nursing care after thrombolysis

Prevention of thrombosis: the limbs with internal fistula should not be burdened, and don't press the limbs when sleeping. You can put a soft pillow on the limb to promote venous blood flow, so as to reduce the degree of swelling, pay attention to the protection of the limb with internal fistula, avoid collision injury, loosen the sleeve and avoid wearing accessories, because the limb with internal fistula can't bear blood pressure. All intravenous treatment and blood drawing should be done, blood pressure should be monitored daily, and antihypertensive drugs should be taken on time to prevent hypertension and avoid hypotension.

Nursing care after thrombolysis: maintenance of venous fistula All patients in this group had subcutaneous congestion at the puncture site after thrombolysis, and were given 5O magnesium sulfate solution hot compress 1 ~ 2 times a day for 3 ~ 5 days to absorb the subcutaneous congestion. In order to effectively prevent thrombosis, puncture should be planned, and the arterial puncture point should be at least 3cm away from the anastomosis to avoid local hemangioma caused by repeated puncture at fixed points. Press the puncture point for 5 ~ 20min after dialysis, and the pressure is moderate.

Set the dry weight correctly. Through health education, patients can improve their self-care ability, control their weight gain during dialysis and avoid excessive ultrafiltration. Because of excessive ultrafiltration, blood viscosity increases, blood pressure decreases and anastomotic blood flow decreases. Can cause thrombosis of internal fistula anastomosis.

Instruct patients and their families to auscultate internal fistula murmur and measure tremor 1 ~ 2 times a day. If the murmur and tremor are found to be weakened or disappeared, suggesting thrombosis, you should go to the hospital immediately to avoid delaying the good opportunity of thrombolytic therapy. It is generally recommended that the time should not exceed 6 hours and the treatment time should not exceed 24 hours.