两种不同溶栓方法治疗维持性血液透析患者自体动静脉内瘘闭塞的效果观察  

The Effect of Two Different Thrombolytic Methods in the Treatment of Autogenous Arteriovenous Internal Fistula Occlusion in Maintenance Hemodialysis Patients

作　　者：王小宏[1] 吴凤金[1] 李全颖[1] 黄素俭[1] WANG Xiaohong;WU Fengjin;LI Quanying;HUANG Sujian(Zhanjiang Central People’s Hospital,Zhanjiang 524023,China)

机构地区：[1]湛江中心人民医院,广东湛江524023

出　　处：《中外医学研究》2020年第10期135-137,共3页CHINESE AND FOREIGN MEDICAL RESEARCH

摘　　要：目的:探讨两种不同溶栓方法治疗维持性血液透析患者自体动静脉内瘘闭塞的效果。方法:选取2018年1月-2019年6月笔者所在科收治的维持性血液透析发生自体动静脉内瘘闭塞的患者87例,按照随机数字表法将其分为观察组(n=44)和对照组(n=43)。对照组采用传统溶栓方法,观察组采用超声引导尿激酶溶栓治疗方法。比较两组溶栓所用时长、尿激酶用量、溶栓后内瘘再通率、溶栓后内瘘堵塞程度及血流量情况。结果:观察组溶栓时长(5.74±2.37)h,尿激酶用量(47.22±8.83)万IU,均优于对照组的(9.82±3.15)h、(72.35±11.46)万IU,差异有统计学意义(P<0.05)。观察组溶栓后内瘘再通率为93.2%,高于对照组的79.1%,差异有统计学意义(P<0.05)。溶栓治疗后,观察组内瘘堵塞程度为(9.26±4.26)%,低于对照组的(22.33±9.14)%,差异有统计学意义(P<0.05)。观察组血流量为(615.74±51.09)ml/min,高于对照组的(487.29±44.16)ml/min,差异有统计学意义(P<0.05)。结论:超声引导尿激酶溶栓治疗维持性血液透析患者自体动静脉内瘘闭塞有利于提高临床疗效,内瘘再通率显著提高。Objective:To explore the effect of two different thrombolytic methods in the treatment of autogenous arteriovenous internal fistula occlusion in maintenance hemodialysis patients.Method:From January 2018 to June 2019,87 patients with autogenous arteriovenous internal fistula occlusion by maintenance hemodialysis in our department were selected.According to the random number table method,the patients were divided into the observation group (n=44) and the control group (n=43).The control group was treated with traditional thrombolysis therapy,and the observation group was treated with ultrasound-guided urokinase thrombolysis therapy.The duration of thrombolysis,the dosage of urokinase,the recanalization rate of internal fistula after thrombolysis,the blocking degree of internal fistula after thrombolysis and the blood flow were compared between the two groups.Result:The duration of thrombolysis in the observation group was (5.74±2.37) h,and the dosage of urokinase was (47.22±8.83)×10~4 IU,which were better than (9.82±3.15) h and (72.35±11.46)×10~4 IU in the control group,the differences were statistically significant (P<0.05).The recanalization rate of internal fistula after thrombolysis was 93.2% in the observation group,which was higher than 79.1% in the control group,the difference was statistically significant (P<0.05).After thrombolysis,the blocking degree of internal fistula in the observation group was (9.26±4.26)%,which was lower than (22.33±9.14)% in the control group,the difference was statistically significant (P<0.05).The blood flow in the observation group was (615.74±51.09) ml/min,which was higher than (487.29±44.16) ml/min in the control group,and the difference was statistically significant (P<0.05).Conclusion:Ultrasound-guided urokinase thrombolysis therapy is helpful to improve the clinical effect and the recanalization rate of internal fistula in maintenance hemodialysis patients.

关 键 词：自体动静脉内瘘闭塞 血液透析 尿激酶 溶栓 临床效果 

分 类 号：R692.5[医药卫生—泌尿科学]