比较不同封管液对颈内静脉长期导管功能的影响  

Effect of Different Lock Solutions on Long-term Catheter Function of Internal Jugular Venous

作　　者：颜伟健[1] 胡杨青[1] 张驰[1] 李君科[1] 王兴健[1] 钟春花[1] YAN Weijian;HU Yangqing;ZHANG Chi(The Second Affiliated Hospital of Shaoyang University,Shaoyang City,Hu’nan Province 422000)

机构地区：[1]邵阳学院附属第二医院,湖南省邵阳市422000

出　　处：《医学理论与实践》2020年第7期1054-1056,共3页The Journal of Medical Theory and Practice

基　　金：邵阳市指导性科技计划项目(2015ZD04)。

摘　　要：目的:观察不同浓度肝素和尿激酶封管液对颈内静脉长期导管功能的影响.方法:选取2015年3月—2017年3月在我院留置颈内静脉长期导管的血液透析患者83例,将患者随机分为浓度为50mg/ml纯肝素、浓度为33.3mg/ml肝素、浓度为25 000U/ml尿激酶、浓度为10 000U/ml尿激酶四组,比较四组在第3、6、9、12个月导管功能不良发生率.将发生导管功能不良的患者应用"尿激酶30万U静脉滴注"通畅后分为服用"华法林""拜阿司匹林"二组,比较二组第3、6、9、12 个月导管通畅情况.结果:各组在第3、6、9、12个月时间点导管功能不良发生率均无统计学意义(P>0.05);患者发生导管功能不良,经尿激酶溶栓再通后,用浓度为33.3mg/ml肝素封管,"华法林"和"拜阿司匹林"二组在第3、6、9、12个月时间点导管功能不良发生率均无统计学意义(P>0.05).结论:不同浓度的肝素与尿激酶封管液对血液透析患者颈内静脉长期导管功能的影响无明显差别,均可有效预防导管血栓;导管溶栓再通后,可不需要服用华法林抗凝来预防血栓形成.Objective:To observe the effects of different concentrations of heparin and urokinase on the long-term catheter function of internal jugular venous.Methods:we selected 83 hemodialysis patients with long-term internal jugular vein catheter from March 2015 to March 2017,the patients were randomly divided into four groups:50mg/ml heparin,33.3mg/ml heparin,25000U/ml urokinase and 10000U/ml urokinase.The incidence of catheter dysfunction was compared among the four groups at 3,6,9 and 12 months.Patients with catheter dysfunction were divided into two groups:warfarin group and aspirin group.The catheter patency was compared between the two groups at 3,6,9 and 12 months.Results:There was no significant difference in the incidence of catheter dysfunction at 3,6,9 and 12 months in each group(P>0.05).After recanalization with urokinase,the catheter was sealed with 33.3mg/ml heparin at 3,6,9 and 12 months in Warfarin and Baiaspirin groups.There was no significant difference in the incidence of tube dysfunction(P>0.05).Conclusion:The effects of different concentrations of heparin and urokinase on the long-term catheter function of internal jugular vein were not significantly different in hemodialysis patients,and both of them could effectively prevent catheter thrombosis.After thrombolysis recanalization,warfarin is not necessary to prevent thrombosis.

关 键 词：导管 肝素 尿激酶 封管液 

分 类 号：R692.5[医药卫生—泌尿科学]