改良尿激酶溶栓术治疗人工血管动静脉内瘘急性血栓形成临床效果观察  

Clinical effect of modified urokinase thrombolysis in the treatment of acute thrombosis in arteriovenous graft

作　　者：温穗溱 潘玉金 许元文[1] 李影花[1] 王饶萍[1] WEN Suizhen;PAN Yujin;XU Yuanwen;LI Yinghua;WANG Raoping(Blood Purification Center,The First Affiliated Hospital Sun Yat-sen University,Guangzhou,Guangdong,510080;Department of Endocrinology,The First Affiliated Hospital Sun Yat-sen University,Guangzhou,Guangdong,510080)

机构地区：[1]中山大学附属第一医院血液净化中心,广东广州510080 [2]中山大学附属第一医院内分泌科,广东广州510080

出　　处：《中西医结合护理》2024年第3期204-208,共5页Chinese Journal of Integrative Nursing

摘　　要：目的评价改良尿激酶溶栓术治疗人工血管动静脉内瘘急性血栓形成的临床应用效果。方法选取2020年11月—2023年2月中山大学附属第一医院血液净化中心发生人工血管动静脉内瘘急性血栓形成导致动静脉内瘘闭塞的维持性血液透析患者26例,超声引导下经皮穿刺血透套管针,抽吸血栓及采用改良方法推注尿激酶。统计并发症情况及人工血管再通率。结果22例患者在超声引导下使用血透套管针抽取部分血栓并顺利推注尿激酶,术后均能扪及震颤及搏动,4例溶栓失败,人工血管动静脉内瘘溶栓成功率84.62%(22/26)。所有患者术后未出现严重并发症。结论人工血管动静脉内瘘发生急性闭塞时,在超声引导下使用透析套管针行尿激酶溶栓,并采用改良的尿激酶推注方法,人工血管复通率较高,减少了尿激酶用量,且无明显并发症。Objective To evaluate the modified urokinase thrombolysis in the treatment of acute thrombosis in arteriovenous graft(AVG).Methods Totally 26 maintenance hemodialysis patients with occlusion of AVG caused by development of thrombosis were included as research subjects.Ultrasound-guided percutaneous insertion of catheter was performed,and a modified method of urokinase infusion was carried out followed by the manual aspiration of thrombus using ultrasound-guided catheters.Complications and recanalization of occluded AVG were observed and analyzed after intervention.Results The successful rate of thrombolytic therapy with uroki-nase was 84.62%(success in 22 cases and failure in 4 cases).There was no serious complication reported after intervention.Conclusion The modified method of urokinase infusion followed by the manual aspiration of thrombus using ultrasound-guided catheters is effective in the treatment of acute thrombosis in AVG.The modified method may help to reduce the dosage of urokinase and incidence of complications after intervention.

关 键 词：血透套管针 尿激酶溶栓 人工血管动静脉内瘘 血栓形成 动静脉内瘘闭塞 

分 类 号：R473.6[医药卫生—护理学]