Efficacy of Multi-drug Mucopolysaccharide Polysulfonate,Clopidogrel,Urokinase Combined with Four-step Massage in the Treatment of Arte-riovenous Fistula Thrombosis and its Influence on Serum hs-CRP,HMGB-1,sEPCR and other Related Factors
To investigate the therapeutic effect of multi-drug mucopolysaccharide polysulfonate,clopidogrel and urokinase combined with four-step massage in the treatment of arteriovenous fistula thrombosis,a total of 78 patients with arteriovenous fistula thrombosis in the hospital from December 2020 to December 2022 were randomly divided into two groups,39 cases in each group.The control group was treated with polysulfonic mucopolysaccharide,clopidogrel,urokinase,etc.On the basis of this,the observation group was treated with four-step massage.The rate of local hematoma,thrombolysis time,internal fistula reperfusion rate,fistula opening area,internal fistula blood flow,prothrombin time(PT),highly sensitive C-reactive protein(hs-CRP),activated partial thrombin time(APTT),high mobility group protein 1(HMGB-1),fibrinogen(FIB),D-dimer(D-D),solubility endothelial cell protein C receptor(sEPCR),clinical efficacy,adverse reactions,rethrombosis were compared between the two groups.After treatment,the fistula reclo-sure rate in the observation group was[82.05％(32/39)]higher than that in the control group[53.85％(21/39)],the local hematoma rate of[20.51％(8/39)]was lower than that in the control group[48.72％(19/39)],and the thrombus lysis time was shorter than that in the control group(P＜0.05).After treatment,the blood flow and fistula area in the observation group were higher than those in the control group(P＜0.05).After treatment,the levels of HMGB-1,D-D,hs-CRP,FIB and sEPCR in observa-tion group were lower than those in control group,while the levels of PT and APTT were higher than those in control group(P＜0.05).The total effective rate of observation group was[92.31％(36/39)]higher than that of control group[74.36％(29/39)](P＜0.05).The incidence of adverse reactions in the observation group was[17.95％(7/39)]compared with[7.69％(3/39)]in the control group(P＞0.05).The incidence of re-thrombosis in the observation group was[2.56％(1/39)]lower than that in the control group[15.38％(6/39)]within 3 months after treatment(P＜0.05).Four-step massage combined with clopidogrel,mucopolisaccharide polysulfonate,urokinase and other drugs is reliable and safe in the treatment of patients with arteriovenous fistula thrombosis.It can regulate coagulation indexes and serum inflammatory mediators,thereby reducing local hematoma,enhancing blood flow,improving the rate of fistula reconstruction,and inhibiting the recurrence of thrombosis.
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