Objective To observe the effect of urokinase thrombolytic therapy on autologous arteriovenous fistula thrombosis in patients with hemodialysis,and to explore its influencing factors.Methods A total of 85 patients with the first autologous arteriovenous fistula thrombosis in the blood purification center from January 2017 to July 2022 were selected as the study objects.According to the thrombolytic effect of urokinase,they were divided into the failed thrombolytic group(58 cases)and the successful thrombolytic group(27 cases).The general characteristics,related data of thrombolysis,internal fistula,dialysis and laboratory indicators of the two groups of patients were collected,and univariate and Logistic regression analysis was performed.Results Among the 85 patients with first internal fistula thrombosis,27 cases(31.8％)were successfully treated with urokinase.Univariate analysis showed that age,dialysis age,the use time of internal fistula and fibrinogen were the influence factors of thrombolytic effect of urokinase(P＜0.05).Logistic regression analysis showed that age(OR=0.270,95％CI:0.082～0.894),the use time of internal fistula(OR=0.206,95％CI:0.063～0.678),fibrinogen(OR=6.209,95％CI:1.894～20.358)were independent influence factors of efficacy of urokinase thrombolytic therapy.The effective rate of thrombolytic therapy was higher in patients with age ≤65 years,the use time of internal fistula≤ 12 months and fibrinogen＞400 mg/dl.Conclusion The success rate of urokinase thrombolytic therapy is 31.8％in patients with first fistula thrombosis,and the therapeutic effect is related to the age of patients,the use time of internal fistula and the level of fibrinogen.
万方数据
维普
