摘要
目的 探讨长期血透导管置管术后尿激酶早期应用对预防导管血栓性并发症的效果。方法 前瞻性选择2021年3月至2023年2月在广西科技大学第一附属医院肾内科接受长期血透导管植入术的血液透析120名患者为研究对象。按照随机数字的方法分为观察组和对照组,每组60例。全部患者均接受长期血透导管置管术。观察组应用尿激酶与肝素混合液于手术结束时封管并于每两周定期封管。对照组应用肝素于手术结束时单纯使用肝素液封管,应用尿激酶与肝素混合液于术后两周封管并每两周定期封管。对比两组患者的导管通畅性指标、导管功能不良情况、因导管功能不良而产生的医疗费用情况以及用药毒副作用。结果 观察组平均血流量、尿素清除指数(Kt/V)数值均高于对照组(P<0.05)。观察组导管功能不良出现率低于对照组(P<0.05)。观察组因导管功能不良而产生的医疗费用低于对照组(P<0.05)。两组患者的用药毒副作用发生率的数据比较,差异无统计学意义(P>0.05)。结论 长期血透导管置管术后尿激酶早期应用对预防导管血栓性并发症具有积极的作用,并且安全性良好,值得推广使用。
【Objective】To investigate the effect of early application of urokinase on the prevention of thrombotic complications after long-term hemodialysis catheter catheterization.【Methods】From March 2021 to February 2023,120 hemodialysis patients who received long-term hemodialysis catheter implantation in the Department of Nephrology,the First Affiliated Hospital of Guangxi University of Science and Technology were prospectively selected for this study.They were divided into two groups according to the method of random number,the observation group and the control group,with 60 patients in each group.All patients underwent long-term hemodialysis catheterization.In the observation group,urokinase and heparin were used to seal the tube at the end of the operation and periodically every 2 weeks.The control group was treated with heparin solution alone at the end of the operation,and was treated with urokinase and heparin mixture solution 2 weeks after the operation to seal the tube and periodically every 2 weeks.The indexes of catheter patency,the malfunctioning of the catheter,the medical expenses caused by poor catheter function,and the side effects of drugs were compared between the two groups.【Results】The mean blood flow and Kt/V of observation group were higher than those of control group(P<0.05).The incidence of catheter dysfunction in observation group was lower than that in control group(P<0.05).The medical expenses of patients in the observation group due to poor catheter function were lower than those in the control group(P<0.05).There was no significant difference in the incidence of drug toxicity between 2 groups(P>0.05).【Conclusion】The early application of urokinase after long-term hemodialysis catheter catheterization has a positive effect on the prevention of thrombotic complications in the catheter,and it is safe and worthy of popularization.
作者
吴杰
廖婷婷
秦雁雄
黎丽芳
WU Jie;LIAO Tingting;QIN Yanxiong;LI Lifang(Nephrology Department,the First Affiliated Hospital of Guangxi University of Science and Technology,Liuzhou,Guangxi 545002,China)
出处
《中国医学工程》
2025年第1期46-50,共5页
China Medical Engineering
基金
广西医疗卫生适宜技术开发与推广应用项目(S2021120)。
关键词
尿激酶
导管血栓性并发症
透析
肝素
毒副作用
urokinase
catheter thrombotic complications
dialysis
heparin
toxic and side effects
