Effect of self-management and thrombus monitoring on patients with autogenous arteriovenous fistula.

Objective: the objective of this study is to explore the effect of a self-management mode on hemodialysis in autogenous arteriovenous fistula patients, and assess the improvement in their self-care, as well as the management and protection abilities of patients through the self-management mode, so as to improve the quality of dialysis.

Method: A total of 100 patients undergoing maintenance hemodialysis, who have autogenous fistula and were cared for in the First Affiliated Hospital of Wenzhou Medical University from August 2019 to February 2020 were selected. All patients were divided into either an experimental group (group A, 50 people) or a control group (group B, 50 people), at random. Patients in group A were given self-management education and self-protection behavior education of internal fistulas based on routine nursing, while patients in group B were only given routine nursing. Initially, the general clinical data between the two groups was compared. Then, the patient self-management scale and internal fistula quality assessment were used to evaluate the patients' self-management ability and internal fistula quality. A Philips ClearVue 850 color Doppler ultrasound diagnostic instrument was used to monitor thrombus in patients.

Results: we found no significant difference in gender, dialysis frequency (3 times a week), dialysis time and blood biochemical indexes between the two groups (P > 0.05). There were statistically significant differences in the self-management ability, internal fistula quality, time effect, grouping effect and interaction effect between the two groups before and after the experiment (P < 0.001). The result of the ultrasound examination show that 75 patients with arteriovenous fistula results were normal, while 25 patients had complications, including 11 patients with steal phenomenon, 8 patients with stenosis, and 6 patients had thrombosis.

Conclusion: self-management intervention and ultrasonic thrombus monitoring for hemodialysis patients can improve the quality of autogenous arteriovenous fistulas, and help doctors treat patients according to their individual complications and improve the cure rate of the disease.