血液透析患者动静脉内瘘血栓形成的治疗方法  

Treatment of Arteriovenous Fistula Thrombosis in Hemodialysis Patients

作　　者：李磊 曹昉 冷彦飞 

机构地区：[1]凉山州第一人名医院肾病内科,西昌615000

出　　处：《血栓与止血学》2017年第4期628-630,共3页Chinese Journal of Thrombosis and Hemostasis

摘　　要：目的探讨尿激酶治疗血液透析患者动静脉内瘘血栓形成的临床效果。方法选取我院50例长期维持性血液透析患者展开研究,对其注射5至50万U尿激酶实施局部溶栓处理,患者治疗前后均施行血管彩色超声诊断,对血浆纤维蛋白原(Fbg)、凝血酶原时间(PT)、肝肾功能进行检测,测定血压,记录不良反应发生率。结果 44例(88.00%)溶栓成功,6例失败(12.00%)。注射尿激酶(47.34±62.85)min后,血栓消除。失败的6例当中有2例血栓形成时间超过48 h,均因血栓性静脉炎。血栓形成时间小于48 h有47例,其中43例(91.49%)治疗成功。所有患者均未出现栓塞与出血,用药后发热的患者有2例,体温未超过38℃,24 h内发热现象消失。结论应用尿激酶治疗血液透析患者动静脉内瘘血栓形成损伤较小,不良反应发生率较低,成功率高,且操作简便,具有较强的临床推广与使用价值。而在治疗血栓性静脉炎、血栓陈旧以及女性患者方面,尿激酶的临床疗效并不显著。Objective Clinical effect of urokinase in the treatment of thrombosis in arteriovenous fistula in hemodialysis patients. Methods A total of 50 patients with long-term hemodialysis of patients, the implementation of the injection of 5 to 500 thousand U of urokinase treatment, patients before and after treatment was performed on color ultrasound in the diagnosis of vascular, plasma fibrinogen （Fbg） , prothrombin time（PT） ,liver and kidney function were detected, and to measure the blood pressure, adverse reaction rate. Results Thrombolysis was successful in 44 cases （88%） and failed in 6 cases （ 12% ）. After injection of urokinase （47.34 ± 62. 85 ） rain, the thrombus was eliminated. 6 failure cases included 2 cases of thrombosis in more than 48 hours, because of thrombophlebitis. There were 47 cases of thrombosis time less than 48 hours, of which 43 cases （ 91.49% ） were successfully treated. There were no embolism and bleeding in all patients. There were 2 cases of patients with fever after drug administration, and the temperature was not more than 38 degrees Celsius, and the fever disappeared within 24 hours. Conclusion Application of urokinase in the treatment of hemodialysis patients with arteriovenous fistula thrombosis injury is small, the incidence of adverse reactions is low, the success rate is high, and the operation is simple, with strong clinical promotion and use value. In the treatment of thrombotic phlebitis, thrombosis and old female patients, no significant clinical effect of urokinase.

关 键 词：血液透析 动静脉内瘘 血栓 

分 类 号：R459.5[医药卫生—治疗学]