血液透析患者改良引血法对股静脉留置导管血栓形成的影响  

Effects of the Modified Blood Drainage Method on Reducing Incidence of Thrombosis in Femoral Venous Catheter among Hemodialysis Patients

作　　者：刘小平 张慧 张桂玉 范德环 杨俊恩 郭冬梅 

机构地区：[1]河北省唐山市工人医院血液透析室,063000

出　　处：《中国全科医学》2014年第15期1704-1706,共3页Chinese General Practice

摘　　要：目的探讨改良引血法对降低血液透析患者股静脉留置导管血栓形成的影响。方法选取2009年4月—2013年1月唐山市工人医院血液透析室经股静脉留置导管进行血液透析的患者292例,采用随机数字表法分为2组,应用常规引血法患者110例,应用改良引血法患者182例。于血液透析时分别采用常规引血法和改良引血法,并于血液透析1、2、3周时行导管内、导管周围及下肢深静脉彩色多普勒超声检查,对比两组血栓形成的发生率。结果血液透析1周时,改良引血法组血栓形成的发生率(1例,0.55%)略低于常规引血法组(3例,2.73%),差异无统计学意义(χ2=1.065,P=0.302)。血液透析2周时,改良引血法组血栓形成的发生率(4例,2.20%)低于常规引血法组(11例,10.00%),差异有统计学意义(χ2=8.565,P=0.003)。血液透析3周时,改良引血法组血栓形成的发生率(9例,4.95%)低于常规引血法组(21例,19.09%),差异有统计学意义(χ2=14.883,P=0.000)。结论改良引血法能有效降低3周内血液透析患者股静脉留置导管血栓形成的发生。Objective To explore the effects of modified blood drainage method on reducing incidence of thrombosis in femoral venous catheter among hemodialysis patients.Methods A total of 292 patients who received hemodialysis through femoral venous catheter at division of hemodialysis in Tangshan Worker＇s Hospital from April 2009 to January 2013,were randomly divided into 2 groups.110 patients were treated with conventional blood drainage method,and 182 patients were treated with modified blood drainage method.The two groups received hemodialysis using conventional blood drainage method and modified blood drainage method,respectively,one week,two weeks and three weeks after the onset of dialysis,color Doppler ultrasound was used to check thrombosis within or around catheter,or in lower limb deep vein.The incidence of thrombus was compared between the two groups.Results 1 week after the onset of dialysis,incidence of thrombus in modified blood drainage method group（1 case,0.55%） was lower than that（3 cases,2.73%） in conventional blood drainage method group,the difference was not significant（χ2= 1.065,P = 0.302）.2 weeks after the onset of dialysis,incidence of thrombus in modified blood drainage method group（4 cases,2.20%） was significantly lower than that（11 cases,10.00%） in conventional blood drainage method group,the difference was significant（χ2= 8.565,P = 0.003）.3 weeks after the onset of dialysis,incidence of thrombus in modified blood drainage method group（9 cases,4.95%） was significantly lower than that（21 cases,19.09%） in conventional blood drainage method group,the difference was significant（χ2= 14.883,P = 0.000）.Conclusion Modified blood drainage method can effectively reduce incidence of thrombosis in femoral venous catheter among patients who receive hemodialysis within 3 weeks.

关 键 词：血液透析滤过 血栓栓塞 导管插入术 股静脉 

分 类 号：R459.52[医药卫生—治疗学]