血管通路對長期血液透析病人來說非常重要，然而每個病人卻必須忍受每年約300 多針動靜脈瘻管穿刺引發的壓力與疼痛，這種長期的壓抑將造成憂鬱症產生進而影響生 活品質。因此，本研究旨在透過文獻回顧試圖找出非侵入性介入措施以緩解血液透析病 人瘻管穿刺疼痛之方案。搜尋2000 年1 月至2017 年12 月，國內外相關資料庫：Airiti Library 華藝線上圖書館、台灣博碩士論文知識加值系統、Cochrane Library、 PubMed、 MEDLINE、Web of Science、CINAHL、 ProQuest、Science Direct 等，關鍵字為血液透 析病人（hemodialysis patient）、動靜脈瘻管（arterio-venous fistula; vascular）、穿刺（needle puncture; venipuncture; insertion of ）和疼痛（Pain）確立搜索範圍，最後共6 篇隨機實 驗控制設計的研究被納入本文，其中1 篇為音樂療法、2 篇芳香療法、2 篇使用麻醉藥 與1 篇冰敷。研究結果顯示各種介入措施皆有不同程度減輕穿刺疼痛之成效。期望透過 本文可作為臨床護理人員與血液透析病人提供許多減輕疼痛方案之參考。

Vascular access plays an important role for long-term hemodialysis patients. Patients under hemodialysis expose to approximately 300 arteriovenous fistula punctures per year, causing frequent stress and pain. This recurrent pain can lead to depression and reduce quality of life. The purpose of this literature review was to elucidate the effects of non-invasive strategies to reduce puncture pain for hemodialysis patients. Search from January 2000 to December 2017, in the database including Airiti Library, Guide to periodicals published in Taiwan, Cochrane Library, Pub Med, Medline, Web of Science, CINAHL, ProQuest,and Science Direct, by the keyword search hemodialysis patient, arterio-venous fistula, needle puncture and pain, total six randomized controlled studies were included in this review. The therapies used in these studies included: one for music therapy, two for lavender aromatherapy, two using anesthesia and one for cryotherapy. The results showed each intervention has varying degrees on reducing puncture pain. Therefore, we expect to provide clinical nurses and hemodialysis patients methods for reducing pain in this article.