尿激酶加肝素混合液不同封管方式对长期透析导管溶栓效果的观察
Expression of thrombolytic effect of urokinase plus heparin mixed with different sealing methods on long-term dialysis catheter
路建秋 1宋树斌 1夏伟琴 1李丹琦 1梁华梅 1蒋佳佳1
作者信息
- 1. 桐乡市中医医院 血透室,浙江 桐乡 314500
- 折叠
摘要
目的 探讨尿激酶加肝素混合液不同封管方式对长期透析导管溶栓的效果.方法 从桐乡市中医医院血透室收治的维持性血液透析留置中心静脉导管伴有导管血栓形成的患者当中抽取63例作为临床研究对象.采用简单随机法将患者分为观察组和对照组.观察组31例,采用正压封管方式从永久性双腔透析导管动静脉两端注入尿激酶、肝素混合液,保留24h,连续3d.对照组32例,从永久性双腔透析导管动静脉两端用微量泵泵入尿激酶,维持2h.结果 2组患者的溶栓成功率无显著差异.观察组患者的导管留置时间明显长于对照组,透析血流量、溶质清除指数、尿素清除指数明显高于对照组,静脉压及出血不良事件发生率明显低于对照组,结果对比差异有统计学意义(P<0.05). 结论 尿激酶加肝素混合液正压封管法操作简单,避免了尿激酶过多进入患者血液循环所带来的潜在性局部或全身出血的风险,值得推广使用.
Abstract
Objective To investigate the effect of different sealing methods of urokinase plus heparin on long-term dialysis catheter thrombolysis.Methods63 patients were treated with maintenance hemodialysis from central venous catheters with catheter thrombosis as a clinical study.The patients were divided into observation group and control group by simple random method.In the observation group, 31 cases were treated with urokinase and heparin mixed solution from the ends of the arteriovenous catheter of permanent double-laryngeal dialysis tube for 24 hours for 3 consecutive days.32 patients in the control group, from the permanent dual-chamber dialysis catheter arterial and vein at both ends with a micro pump pumped urokinase, maintained for 2hours.ResultsThere was no significant difference in thrombolytic success rate between the two groups.The catheter retention time in the observation group was significantly longer than that in the control group, the dialysis blood flow rate, the solute clearance index and the urea clearance index were significantly higher than those in the control group.The incidence of venous pressure and hemorrhagic adverse events was significantly lower than that of the control group (P<0.05).ConclusionUrea kinase plus heparin mixture is simple and easy to operate, which avoids the risk of excessive localized or systemic hemorrhage caused by excessive urokinase into the blood circulation of patients.It is worthy of popularization.
关键词
尿激酶/肝素/封管/长期透析/溶栓Key words
urokinase/heparin/sealing tube/long-term dialysis/thrombolysis引用本文复制引用
基金项目
桐乡市第二批科技计划项目(201303207)
出版年
2017
NETL
NSTL
维普
万方数据