摘要目的:观察微视频突破教育与专题工作坊联用于维持性血液透析患者内瘘护理中的效果，为改善患者预后提供依据。方法:采用随机对照试验，以便利抽样法选择2022年1—12月就治于浙江中医药大学附属湖州中医院的维持性血液透析内瘘患者90例为观察对象，以随机数字表法将患者分为对照组和试验组各45例，对照组采用维持性血液透析内瘘常规护理，试验组引入微视频突破教育与专题工作坊联合干预机制，对2组干预后的内瘘自护行为等各项观察指标进行比较。结果:对照组男23例，女22例，年龄（58.07 ± 3.00）岁；试验组男24例，女21例，年龄（58.93 ± 4.07）岁。干预后，试验组内瘘自护行为总分为（49.44 ± 1.84）分，对照组为（38.93 ± 2.19）分，2组比较差异有统计学意义（ t = 24.65， P<0.05）；试验组健康管理依从性中液体摄入、透析方案、药疗、饮食评分分别为（15.82 ± 1.37）、（12.87 ± 1.39）、（17.24 ± 1.33）、（21.60 ± 1.03）分，对照组分别为（11.20 ± 0.92）、（9.98 ± 1.14）、（12.11 ± 1.01）、（17.40 ± 1.10）分，2组比较差异均有统计学意义（ t值为10.78 ~ 20.62，均 P<0.05）；试验组积极心理资本评分中自我效能、韧性、希望、乐观评分分别为（38.69 ± 1.22）、（39.27 ± 1.10）、（33.29 ± 1.52）、（33.40 ± 1.39）分，对照组分别为（31.16 ± 1.26）、（31.04 ± 1.15）、（26.13 ± 1.52）、（27.09 ± 7.28）分，2组比较差异均有统计学意义（ t值为5.71 ~ 34.77，均 P<0.05）。试验组并发症总发生率为8.89%（4/45），低于对照组的28.89%（13/45），差异有统计学意义（ χ2 = 5.87， P<0.05）。 结论:将微视频突破教育与专题工作坊联合应用于维持性血液透析内瘘患者中，利于其内瘘自我护理能力、健康管理依从性、积极心理资本的提升，可降低内瘘并发症发生率。

abstractsObjective:To observe of the effects of micro-video breakthrough education and thematic workshops in the care of internal fistulae in maintenance haemodialysis patients, to provide a basis for improving prognosis of patients.Methods:This study was a randomized controlled trial. A total of 90 cases of maintenance haemodialysis patients with endocardial fistula were selected in Huzhou Hospital of Traditional Chinese Medicine Affiliated to Zhejiang University of Traditional Chinese Medicine from January to December in 2022 as the observation samples using convenience sampling method. They were divided into the experimental group and the control group with 45 cases in each group by the method of random number table. The control group used the conventional nursing care for maintenance haemodialysis endocardial fistula to administer nursing care, the experimental group introduced the micro-video breakthrough education and thematic workshop as a combined mechanism of intervention. The self-care behaviors with arteriovenous fistula and other observation indexes between the two groups were compared.Results:There were 23 males and 22 females in the control group, aged (58.07 ± 3.00) years old. There were 24 males and 21 females in the experimental group, aged (58.93 ± 4.07) years old. After care, the total internal fistula self-care behaviour score in the experimental group was (49.44 ± 1.84) points, and (38.93 ± 2.19) points in the control group, the difference between the two groups were statistical significant ( t = 24.65, P<0.05). For health management adherence, the score of fluid intake, dialysis regimen, medication and dietary dimension were (15.82 ± 1.37), (12.87 ± 1.39), (17.24 ± 1.33) and (21.60 ± 1.03) points in the experimental group, and (11.20 ± 0.92), (9.98 ± 1.14), (12.11 ± 1.01) and (17.40 ± 1.10) points in the control group, the difference between the two groups were statistical significant ( t values were 10.78 to 20.62, all P<0.05). For positive psychological capital, the scores of self-efficacy, resilience, hope and optimism were (38.69 ± 1.22), (39.27 ± 1.10), (33.29 ± 1.52) and (33.40 ± 1.39) points, and were (31.16 ± 1.26), (31.04 ± 1.15), ( 26.13 ± 1.52) and (27.09 ± 7.28) points in the control group, the difference between the two groups were statistical significant ( t values were 5.71 to 34.77, all P<0.05). The total complication rate of the experimental group was 8.89% (4/45), lower than 28.89% (13/45) in the control group, and the differences were all statistically significant ( χ2 = 5.87, P<0.05). Conclusions:The combined application of micro-video breakthrough education and special workshops in maintenance hemodialysis patients with internal fistula is beneficial to the improvement of their internal fistula self-care ability, health management compliance and positive psychological capital, and can reduce the probability of internal fistula complications.