干预措施减少血液透析患者动静脉瘘插管相关疼痛的疗效：系统回顾和荟萃分析

IF 1.5 4区医学 Q3 NURSING

Journal of renal care Pub Date : 2025-07-18 DOI:10.1111/jorc.70028

Nurten Ozen, Nese ALTINOK. Ersoy, Gulsah Kesik

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引用次数: 0

摘要

背景：持续疼痛会影响患者血液透析依从性，最终降低生活质量。因此，在这些患者中，疼痛控制是一个重要的优先事项。目前还没有关于干预（有创和无创干预）对动静脉瘘插管相关疼痛影响的系统综述和荟萃分析研究。目的：本系统综述采用荟萃分析来评估干预措施减少血液透析患者动静脉瘘插管相关疼痛的有效性。方法使用PubMed、Web of Science、Scopus、Science Direct、ProQuest、ProQuest dissertation &等英文数据库；从成立到2025年4月，对这些网站和EBSCOHOST进行了系统的检索。两名审稿人使用JBI RCT检查表独立评估偏倚风险。采用综合meta分析软件3.0版（Biostat）进行数据分析。结果22项随机对照试验考察了干预措施对缓解动静脉瘘插管相关疼痛的影响，包括有创和无创干预相关研究。有创干预措施：钮孔插管、塑料针和留置针。非侵入性方法包括冷冻疗法或使用局部皮肤冷却装置、芳香疗法、足部反射疗法、美国引导插管、抗压力球、听音乐或自来水、虚拟现实分心、呼吸运动和对血液透析患者的指压。结论有创性和无创性干预措施对瘘管插管相关疼痛的治疗效果良好。然而，由于异质性和缺乏随访研究，需要更多高质量的研究来证实我们综述的结果，并阐明干预措施的长期效果。

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Efficacy of Interventions to Reduce Arteriovenous Fistula Cannulation-Related Pain in Patients Undergoing Haemodialysis: A Systematic Review and Meta-Analysis

Background

Experiencing continued pain affects the level of haemodialysis adherence in patients and ultimately decrease quality of life. Therefore, pain control is an important priority in these patients. No systematic review and meta-analyses study about the effect of intervention (invasive and noninvasive intervention) on the arteriovenous fistula cannulation-related pain has yet been carried out.

Objectives

This systematic review with meta-analysis was conducted to assess the evidence for the effectiveness of intervention to reduce the arteriovenous fistula cannulation-related pain in patients undergoing haemodialysis.

Methods

Using English databases, including PubMed, Web of Science, Scopus, Science Direct, ProQuest, ProQuest Dissertations & Theses Global, and EBSCOHOST were systematically searched from their inception to April 2025. Two reviewers independently assessed the risk of bias using the JBI RCT checklist. The Comprehensive Meta-Analysis® software version 3.0 (Biostat) was used for data analysis.

Results

Twenty-two randomised controlled trials examined the effects of interventions to alleviate the arteriovenous fistula cannulation-related pain including invasive and noninvasive interventions related studies. Invasive interventions buttonhole cannulation, using plastic needle and using indwelling needles. Noninvasive methods include cryotherapy or using a local skin cooling device, aromatherapy, foot reflexology, US-guided cannulation, antistress balls, listening to music or running water, virtual reality distraction, breathing exercise, and acupressure on patients with haemodialysis.

Conclusion

The study demonstrated that invasive and noninvasive interventions had beneficial effects on the fistula cannulation-related pain. However, due to the heterogeneity and the lack of follow-up studies, more high-quality studies are needed to confirm the results of our review and to clarify the long-term effects of interventions.

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来源期刊

Journal of renal care Nursing-Advanced and Specialized Nursing

CiteScore

3.50

自引率

5.30%

发文量

期刊介绍： The Journal of Renal Care (JORC), formally EDTNA/ERCA Journal, is the official publication of the European Dialysis and Transplant Nursing Association/European Renal Care Association (EDTNA/ERCA). The Journal of Renal Care is an international peer-reviewed journal for the multi-professional health care team caring for people with kidney disease and those who research this specialised area of health care. Kidney disease is a chronic illness with four basic treatments: haemodialysis, peritoneal dialysis conservative management and transplantation, which includes emptive transplantation, living donor & cadavaric transplantation. The continuous world-wide increase of people with chronic kidney disease (CKD) means that research and shared knowledge into the causes and treatment is vital to delay the progression of CKD and to improve treatments and the care given. The Journal of Renal Care is an important journal for all health-care professionals working in this and associated conditions, such as diabetes and cardio-vascular disease amongst others. It covers the trajectory of the disease from the first diagnosis to palliative care and includes acute renal injury. The Journal of Renal Care accepts that kidney disease affects not only the patients but also their families and significant others and provides a forum for both the psycho-social and physiological aspects of the disease.