La punción del acceso vascular en hemodiálisis es una necesidad, el método buttonhole una opción

Abstract

Introduction The access puncture technique, as well as affecting survival, is a cause for anxiety and discomfort for the patient. There are three puncture techniques: rope-ladder, area and buttonhole. Studies carried out on this last method associate it to a reduction in pain and the complications associated to puncture. Aim To introduce the buttonhole puncture method in our Unit. Methodology Observational descriptive study, carried out at our haemodialysis unit. All the patients on haemodialysis with a healthy and non-prosthetic arteriovenous fistula were included in this study. The sample will be 35 randomized patients with a monitoring period of 6 months. Prior to commencing the study, nursing staff were trained in the technique and a specific puncture protocol was created. All the variables to be analysed are recorded at each haemodialysis session. Descriptive statistics is applied for the Student t variable for the difference between means and x2 and Fisher's exact test for the proportions, where p<0.05 is considered significant. Kaplan- Meier survival analysis. SPSS 14.0. statistical package. Results The sensation of pain during puncture and bleeding time were reduced significantly in all patients. No complications occurred during the study period. Conclusions The buttonhole puncture technique reduces the pain perceived by the patient, giving greater satisfaction. The buttonhole puncture technique is a good alternative for accesses that are not well developed or have puncture problems, favouring self-puncture and home haemodialysis options.