透析前短时尿激酶封管对血液透析半永久中心静脉导管功能的影响  

The effect of short-time urokinase sealing before hemodialysis on the function of semi-permanent central venous catheter in hemodialysis

作　　者：彭致远 张莉莉 王岩 王金良 包斯琴 PENG Zhi-yuan;ZHANG Li-li;WANG Yan(Department of Nephrology,Inner Mongolia Xing'an League People's Hospital,Inner Mongolia 137400,China)

机构地区：[1]内蒙古兴安盟人民医院肾内科,内蒙古乌兰浩特137400

出　　处：《吉林医学》2021年第4期843-845,共3页Jilin Medical Journal

摘　　要：目的:研究定期透前短时尿激酶封管对血液透析半永久中心静脉导管功能的影响。方法:选取2016年1月~2018年12月维持性血液透析患者36例,其中男19例,女17例,均使用带cuff导管作为透析通路;随机分为两组:观察组18例,采用透析前给予导管分别注入(5 ml生理盐水+尿激酶10万U)封管液2 ml,并保留30 min后弃掉,透析结束时常规普通肝素封管;对照组18例,透析结束时给予(生理盐水2 ml+肝素2 ml+尿激酶10万U)封管。观察患者透析量指标(Kt/V)、C-反应蛋白(CRP)、血流量、静脉压及导管功能不良等指标。结果:两组比较,BUN、Scr、Alb水平差异无统计学意义(P>0.05);Kt/V、CRP、血流量、静脉压及导管功能不良发生率比较,差异均有统计学意义(P<0.05)。结论:定期透析前短时尿激酶封管可通过患者透析质量,减少导管功能不良的发生,延长导管使用寿命。Objective To study the effect of short-term urokinase catheter sealing on the function of semi permanent central venous catheter in hemodialysis.Method From January 2016 to December 2018,36 patients with maintenance hemodialysis in hemodialysis center of Xingan League people's Hospital in Inner Mongolia were selected,including 19 males and 17 females,all of whom used cuff catheter as dialysis access;They were randomly divided into two groups:the observation group(18 cases),before dialysis were given catheter injection(5 ml normal saline+urokinase 100000 U)sealing solution 2 ml,and kept for 30 minutes,then discarded,at the end of dialysis,routine heparin sealing;In the control group(18 cases),at the end of dialysis,the catheter was sealed(2 ml of normal saline+2 ml of heparin+100000U of urokinase).The indexes of dialysis volume(kt/V),C-reactive protein(CRP),blood flow,venous pressure and catheter dysfunction were observed.Results There was no significant difference in BUN,Scr and Alb between the two groups(P>0.05);there was significant difference in kt/V,CRP,blood-flow,venous pressure and the incidence of catheter dysfunction(P<0.05).Conclusion Short time urokinase sealing before regular dialysis can reduce the occurrence of catheter dysfunction and prolong the service life of catheter through the quality of dialysis.

关 键 词：血液透析 中心静脉导管 C-反应蛋白 KT/V 尿激酶 

分 类 号：R692.5[医药卫生—泌尿科学]