Objective To optimize the environment of outpatient clinics in large hospitals, facilitate the patients’ visits and improve the comprehensive management level. Methods From September to November 2015, 2 hospitals in each part of a provincial city (middle, east, west, north and south), a total of 10 hospitals were chosed by convenient sampling method. The forms, types and distribution of outpatient navigation service system were investigated and analyzed by using a self-designed questionnaire. Results There were a total of 14 forms of counseling-guide services in the 10 hospitals. Just 1 hospital provided all the 14 forms of counseling-guide services, and 2 hospitals provided 13 forms of counseling-guide services, which were relatively complete. While the other 7 large hospitals provided only 4 to 6 forms of counseling-guide services, which were relatively simple. Conclusion Qualified outpatient navigation service system can help patients to receive more effective treatment, optimize the environment, highlighting the modern hospital humanistic service and the concept of intelligent service and scientific management.
Objective To investigate the clinical effect and safety of balloon angioplasty (BAP) for patients with venous hypertension associated with autogenous arteriovenous fistula (AVF). Methods Thirty-three patients with venous hypertension associated with AVF were hospitalized between August 2012 and August 2014 in the Department of Nephrology, West China Hospital of Sichuan University. All of the patients received BAP therapy. The clinical characteristics and therapeutic effects were comparatively summarized before and after operation. Results Venous hypertension in all the 33 patients was caused by central venous stenosis or occlusion. Among them, there were 13 cases of stenosis on the site where the left innominate vein crossed the aorta, 10 cases of stenosis at the junction of the left innominate vein and superior vena cava, 4 cases of stenosis at the junction of the left subclavian vein and the innominate vein, 3 cases of right innominate vein stenosis, and 3 cases of innominate vein occlusion. The lesions were most common in the innominate vein. Innominate vein stenosis or occlusion occurred in 19 cases (57.6%), and stenosis at the junction of innominate vein and the superior vena cava or subclavian vein occurred in 14 cases (42.4%). Of the 33 patients, one patient with complete occlusion of the innominate vein did not receive BAP treatment because guide wire could not pass through the occlusion site. The other 32 patients underwent BAP treatment, among whom 30 (93.8%) were successful, and 2 (6.2%) failed. No obvious complications occurred. One day after BAP treatment, patients’ symptoms were significantly relieved. One to seven days later, swelling of the hands, pain, and other symptoms were relieved. In the 30 patients who underwent the treatment successfully, 29 were followed up for 3 to 24 months. Among them, 21 (72.4%) maintained clinical remission and the AVFs were functional, 6 patients (20.7%) got a restenosis later, and 2 patients died. Conclusions BAP is effective and safe for venous hypertension associated with AVF. However, the follow-up of patients has displayed the possible risk of restenosis in long-term outcomes.
目的 研究自體動靜脈內瘺全程規范化護理的可實施性及優勢。 方法 制定自體動靜脈內瘺全程規范化護理工作流程及標準，將2011年6月－8月經自體動靜脈內瘺行維持性血液透析患者隨機分為觀察組（125例）和對照組（115例），分別予以全程規范化護理和普通護理，對比分析兩組之間內瘺不良事件發生率、患者滿意度、護士認同度等指標的差異。 結果 兩組內瘺不良事件發生率分別為8.0%和21.0%，患者滿意度分別為98.4%和84.3%，差異均有統計學意義（P＜0.05）；兩組護士對本組護理模式認同度均為90.0%，差異無統計學意義（P＞0.05）。 結論 自體動靜脈內瘺全程規范化護理模式能有效降低內瘺不良事件發生率并顯著提高患者滿意度，值得臨床推廣。