乙醇与常规肝素封管在血液透析长期留置导管中的比较研究  

A Comparative Study of Ethanol and Conventional Sealed Tube Heparin Lock

作　　者：唐建英[1] 雷湫宇 曾薇[1] 王沂芹[1] 王代红[1] 赵景宏[1] 

机构地区：[1]第三军医大学新桥医院肾内科,重庆400037

出　　处：《现代生物医学进展》2015年第10期1866-1869,共4页Progress in Modern Biomedicine

基　　金：国家自然科学基金项目(30800528)

摘　　要：目的:比较乙醇封管和常规肝素封管两种方法在长期留置导管维持性血液透析患者中的效果,为临床维持性血液透析患者深静脉置管患者封管方式提供依据。方法:选择长期留置导管的维持性血透患者28例作为研究对象,随机分成实验组和对照组,实验组采用乙醇封管,对照组采用常规肝素封管,观察两组导管相关菌血症及血栓的发生情况及患者微炎症状态,观察48周。结果:乙醇封管组导管相关性感染及炎症指标明显降低,尤其在25-48周(P<0.05);两组患者血栓发生率无明显差别(P>0.05)。结论:乙醇封管比常规肝素封管可有效降低维持性血液透析患者导管相关感染的发生率,且不易导致管腔内凝血,是一种安全、有效的封管方式。Objective： To compare the effect of ethanol tube sealing with conventional heparin tube sealing on the maintenance hemodialysis patients with long-term indwelling catheter., and provide a clinical clue in the tube sealing approach for them. Methods：The ethanol tube sealing approach was used in 14 maintenance hemodialysis patients with long-term indwelling catheter, and the conventional heparin tube sealing approach was used in another 14 patients with the same status. The catheter-related bacteremia（CRB）,thrombus and inflammation in the 28 patients were detected. Results： By using the ethanol tube sealing, the catheter-related inflammatory factorsdecreased markedly, the lowest of which appeared within 25-48 weeks（P0.05）, while the incidence of thrombus showed no significant difference between using the ethanol tube sealing and the conventional tube sealing. Conclusion： Using the ethanol tube sealing could markedly help reduce the catheter-related inflammation rate in patients with maintenance hemodialysis when compared with the conventional tube sealing, and not likely to lead to the thrombus in catheter.

关 键 词：乙醇 肝素 维持性血液透析 长期中心静脉置管 

分 类 号：R459.5[医药卫生—治疗学] R692.5[医药卫生—临床医学]