摘要
目的探讨前列地尔注射液对复杂内瘘的影响。方法选择慢性肾衰欲行血液透析的患者42例,随机分为A组和B组,均行挠动脉-头静脉标准内瘘术。A组术后予低分子肝素5000单位皮下注射共7天;B组术后给予前列地尔注射液10μg静脉注射共7天,同时每天局部考电15 m in,彩色血管多普勒超声检查吻合口情况,采血检测治疗前后活化部分凝血活酶时间﹙APTT﹚、凝血酶原时间﹙PT﹚、血红蛋白﹙H GB﹚、血小板﹙PLT﹚及不良反应。结果 A组有6例术后第1天表现为內瘘处血管震颤减弱、血管杂音降低,经保守治疗同时加强手部功能锻炼1周后好转,3例內瘘闭塞;B组有2例术后第3天出现血管震颤及血管杂音减弱,加强功能锻炼2天后好转。A组有2例糖尿病肾病患者术后第1天和第3天开始出现术肢肿胀,分别瞩其抬高患肢和轻微握拳活动手指,2周后术肢肿胀逐渐消失;B组有1例术后次日出现术肢肿胀,未予处置,1周后肿胀逐渐消失。两组均未发现切口感染及术区渗血情况。彩色多普勒超声检查A组有2例瘘口血流量<600 m l/m in,3例瘘口口径<6 m m;B组血流量均在600 m l/m in以上,1例瘘口口径<6 m m。APTT、PT值治疗后较治疗前延长,有统计学意义﹙p<0.05﹚。H GB、PLT值治疗前后无差异,无统计学意义。结论前列地尔注射液联合局部理疗的方法具有预防动静脉内瘘术后血栓形成,提高手术成功率的作用。
Objective To discuss the influence of alprostadil injection on complex fistula.Methods 42 patients with chronic renal failure for hemodialysis were divided into A group and B group,which were both treated by radial artery-cephalic vein standard fistulation.A group was taken subcutaneous injection for 7 d with 5000 units of low molecular weight heparin after operation;B group was taken intravenous injection for 7 d with 10 μg of alprostadil injection after operation,and local electric grill for 15 min every day.And to examine the anastomotic situation with color vascular doppler ultrasound,and test APTT,PT,HGB,PLT and adverse reactions before and after the treatment.Results 6 patients in A group showed that vascular tremor in fistula was weakened in the first day after operation and vascular murmur was reduced,which recovered in 1 week through the conservative treatment and strengthening hand function training,and 3 patients showed fistula occlusion.2 patients in B group showed that vascular tremor in fistula was weakened and vascular murmur was reduced in the third day after operation,which recovered in 2 days after strengthening function training.2 patients in A group with diabetic nephropathy showed surgery limb swollen in the first and third day after operation,which were asked to raise the limb and activity fingers with a slight fist,swollen surgery limb recovering gradually in 2 weeks.1 patient in B group showed surgery limb swollen in the day after operation,without handling,recovering in 1 week.There were no wound infection and bleeding in both groups.Through color doppler ultrasonography blood flow in fistula of 2 patients in A group was 600 ml/min,caliber in fistula of 3 patients was 6 mm;blood flow in B group was﹥600 ml/min,caliber in fistula of 1 patient was 6 mm.APTT and PT were increased compared to those before the treatment,with statistical significance﹙p0.05﹚.There was no difference among APTT,HGB and PLT before and after the treatment,without statistical significance.Conlusion Alprostadil
出处
《透析与人工器官》
2011年第1期38-40,共3页
Chinese Journal of Dialysis and Artificial Organs
关键词
前列地尔
复杂动静脉内瘘
血栓形成
alprostadil injection
complex arteriovenous fistula
thrombosis
