阿米卡星封管在血液透析患者带隧道、涤纶套导管中的应用  

Application of the lock solution containing amikacin sulfate for tunnelled-cuffed indwelling catheters in maintenance hemodialysis patients

作　　者：覃丹平[1] 钟小仕[1] 陈文璇 何筱娴 胡建广[1] 郑媛媛[1] 

机构地区：[1]广州市红十字会医院肾内科(暨南大学医学院第四附属医院),广州510220

出　　处：《中国血液净化》2016年第2期116-118,共3页Chinese Journal of Blood Purification

摘　　要：目的研究硫酸阿米卡星混合法安明封管对维持性血液透析带隧道、涤纶套导管患者导管相关并发症的影响。方法采取随机分组对照研究,试验组予硫酸阿米卡星混合法安明封管,对照组使用法安明封管。均为20例,观察2组患者导管相关并发症、血泵流量、尿素清除指数(Kt/V)、超敏C反应蛋白(high sensitivity C-reactive proteihs,hs-CRP)、血红蛋白情况及不良反应结果试验组患者导管相关并发症明显低于对照组(40例)患者(导管相关菌血症χ2=4.097,P=0.043;导管功能不良:χ2=11.841,P=0.001;导管血栓形成:χ2=7.978,P=0.005)。试验组(15例)血泵流量(t=-4.233,P=0.000)、Kt/V(t=-8.552,P=0.000)、hs-CRP(t=8.228,P=0.000)及血红蛋白(t=-2.331,P=0.031)较试验前都有明显改善,与对照组比较差异也有统计学意义[血泵流量:t=4.121,P=0.001;Kt/V:t=3.716,P=0.001;hs-CRP:t=-6.415,P=0.000;血红蛋白:t=3.139,P=0.005]。结论硫酸阿米卡星混合法安明封管能有效降低导管相关并发症发生率,改善透析充分性,安全性良好。Objective To determine whether the lock solution of amikacin sulfate/dalteprin sodium injection can prevent catheter-related complications. Methods This was a randomized, prospective and controlled study. Amikacin sulfate/dalteprin sodium injection was applied into catheter lumen in experimental group （n=20）, and dalteprin sodium injection was used as the lock solution in control group （n=20）. They all received hemodialysis 3 times a week for 3 months. The incidences of catheter-related complications and oth- er adverse reactions were recorded. Results Catheter-related complications including bacteremia, catheter dysfunction, and thrombosis in catheter were lower in experimental group than in control group （P〈0.05）. In experimental group, blood flow, Kt/V, hs-CRP and hemoglobin also improved as compared with those before experiment. There were no other adverse reactions in the two groups. Conclusion The lock solution containing amikacin sulfate/dalteprin sodium injection can prove dialysis adequacy. effectively reduce catheter-related complications and improve dialysis adequacy.

关 键 词：硫酸阿米卡星 法安明 血液透析 带隧道和涤纶套的导管 

分 类 号：R318.16[医药卫生—生物医学工程]