摘要
目的使用尿激酶持续泵入法与常规封管溶栓法对深静脉置管功能不良的疗效比较,以期解决局部尿激酶溶栓疗效不佳、易复发的局限性。方法选择2010年1月至2013年12月在解放军第401医院使用深静脉留置导管进行血液透析治疗,临床诊断导管功能不良的42例患者随机分为A组和B组,每组21例。A组使用10万单位尿激酶溶入生理盐水50 ml,持续微量泵2 h泵入动静脉端；B组使用10万单位尿激酶溶于4 ml生理盐水中动静脉端局部封管2 h,比较2组溶栓疗效及凝血指标。结果 A组溶栓后通畅率95.2%,平均血流量（232.0±22.4）ml/min。B组溶栓后通畅率90.5%,平均血流量（219±25.0）ml/min。2组溶栓后通畅率及血流量差异均无统计学意义（P〉0.05）。溶栓成功后15 d,A组通畅率85.7%,B组通畅率61.9%；2组患者通畅率差异有统计学意义。其中 A组患者溶栓当天及溶栓第15天后导管功能良好率无统计学差异（P〉0.05）,但B组患者溶栓当天及溶栓后第15天导管功能良好率有统计学差异（P〈0.05）。2组患者未出现出血、发热、皮疹、过敏等明显的不良反应。结论尿激酶持续泵入法比局部封管溶栓法治疗成功率高,15 d 后通畅率高,无明显不良反应。
Objective To compare the efficacy and safety of continuous micropumpvs.conventional sealed tube in the treatment of patients with late dysfunction of deep venous catheter,and to solve the limitation of conventional sealed tube.Methods Clinical data were collected from 42 patients with late dysfunction of deep venous catheter who were treated with hemodialysis treatment because of uremia from January 2010 to August 2013.These patients were randomly assigned to group A and group B.The patients in group A were treated with continuous micro pump using 1 00 000 U of uroki-nase dissolved in 50 mL saline for 2 h,and those in group B were treated with conventional sealed tube using 1 00 000 U of urokinase dissolved in 4 mL saline.The thrombolysis and recanalization rate was assessed and compared between the two groups after the treatment for 2 weeks.Results Therateof thrombolysis and recanalization in groups A and B was 95.2% and 90.5% respectively （P〉0.05）. After 2 weeks,the rate of thrombolysis and recanalization in groups A and B was 85.7% and 61.9%respectively （P〈0.05）.No side effects of bleeding and OB,etc occurred in both two groups.Conclusions As compare with the conventional sealedtube,the use of continuous micro pump treatment significantly increase the rate of thrombolysis and recanalization at 2nd week post-thrombosis in the pa-tients with late dysfunction of deep venous catheter.
出处
《临床肾脏病杂志》
2014年第8期480-483,共4页
Journal Of Clinical Nephrology
关键词
深静脉置管
血栓
尿激酶
溶栓
血液透析
Deep venous catheters
Thrombus
Urokinase
Thrombolysis
Hemodialysis
