华法林与氢氯吡格雷预防维持性血液透析长期导管功能不良的效果比较  

Comparison of the efficacy of warfarin and hydroclopidogrel in preventing long-term catheter dysfunction in maintenance hemodialysis

作　　者：余芳 江新爱 YU Fang;JIANG Xin′ai(Department of Nephrology,the Second People′s Hospital of Jingdezhen,Jiangxi Province,Jingdezhen 333000,China)

机构地区：[1]江西省景德镇市第二人民医院肾内科,333000

出　　处：《临床合理用药杂志》2024年第32期30-33,37,共5页Chinese Journal of Clinical Rational Drug Use

基　　金：景德镇市科技计划项目(20221SFZC042)。

摘　　要：目的比较华法林与氢氯吡格雷预防维持性血液透析(MHD)长期导管功能不良的效果。方法选取2021年1月—2023年6月在景德镇市第二人民医院建立带隧道带涤纶套中心静脉导管患者80例为研究对象,以随机数字表法分为华法林组27例,氢氯吡格雷组27例和空白对照组26例。空白对照组不服用抗凝药,华法林组口服华法林钠片,氢氯吡格雷组口服硫酸氢氯吡格雷片,观察期为1年。比较3组干预前后血常规、血肌酐、血尿素氮、血钙、血磷水平,干预后导管功能情况、导管功能不良次数、导管堵塞次数及出血事件发生次数。结果干预1年后,3组血红蛋白水平均升高,白细胞计数均降低,且华法林组变化程度大于氢氯吡格雷组和空白对照组,氢氯吡格雷组变化程度大于空白对照组(P<0.01);3组血小板计数干预前后及组间比较差异均无统计学意义(P>0.05)。3组血肌酐、血尿素氮及血磷水平均下降,血钙水平均上升,且华法林组变化程度大于氢氯吡格雷组和空白对照组,氢氯吡格雷组变化程度大于空白对照组(P<0.05或P<0.01)。华法林组血流量、尿素清除指数高于氢氯吡格雷组和空白对照组,且氢氯吡格雷组高于空白对照组(P<0.01);华法林组导管静脉压、溶栓次数、尿激酶溶栓次数均低于氢氯吡格雷组和空白对照组,且氢氯吡格雷组低于空白对照组(P<0.01);华法林组与氢氯吡格雷组拔管例数均少于空白对照组(P<0.01),但华法林组与氢氯吡格雷组比较差异无统计学意义(P>0.05)。华法林组导管功能不良次数、导管堵塞次数均低于氢氯吡格雷组和空白对照组,且氢氯吡格雷组低于空白对照组(P<0.01);华法林组和空白对照组出血事件发生次数低于氢氯吡格雷组(P<0.01),而华法林组和空白对照组出血事件发生次数比较差异无统计学意义(P>0.05)。结论华法林能有效保证导管功能的正常运作,且在预防血液透�Objective To compare the efficacy of warfarin and hydrogen clopidogrel in preventing long-term catheter dysfunction in maintenance hemodialysis(MHD).Methods A total of 80 patients with tunnel-cuffed catheter in the Second People′s Hospital of Jingdezhen from January 2021 to June 2023 were selected as the research objects.According to the random number table method,they were divided into the warfarin group(27 cases),the hydrogen clopidogrel group(27 cases)and the blank control group(26 cases).The blank control group did not take anticoagulants,the warfarin group took oral warfarin sodium tablets,and the hydrogen clopidogrel group took oral clopidogrel bisulfate tablets.The observation period was 1 year.The routine blood test,serum creatinine,blood urea nitrogen,blood calcium and blood phosphorus levels before and after intervention were compared among the three groups.The catheter function,the frequency of catheter dysfunction,catheter blockage and bleeding events after intervention were compared among the three groups.Results After 1 year of intervention,the hemoglobin level increased and the white blood cell count decreased in the three groups,and the changes in the warfarin group were greater than those in the hydrogen clopidogrel group and the blank control group,and the changes in the hydrogen clopidogrel group were greater than the blank control group(P<0.01).There was no significant difference in platelet count before and after intervention among the three groups(P>0.05).The levels of serum creatinine,blood urea nitrogen and blood phosphorus decreased,the level of serum calcium increased in the three groups,and the changes in the warfarin group were greater than those in the hydrogen clopidogrel group and the blank control group,and the changes in the hydrogen clopidogrel group were greater than those in the blank control group(P<0.05 or P<0.01).The blood flow and urea clearance index in the warfarin group were higher than those in the hydrogen clopidogrel group and the blank control group,and those in th

关 键 词：维持性血液透析 华法林 氢氯吡格雷 带隧道带涤纶套中心静脉导管 导管功能不良 

分 类 号：R692.5[医药卫生—泌尿科学]