摘要
目的 研究定期尿激酶联合肝素封管对血液透析患者长期导管预防感染的影响，阐明定期应用尿激酶联合肝素封管的临床意义。方法 选用2014年4月-2015年3月在我院透析中心使用右颈内静脉带cuff长期透析导管作为血管通路行维持性血液透析患者60例，随机分为2组（实验组和对照组各30例）。实验组每周一次尿激酶联合肝素盐水封管，其余透析后肝素盐水封管；对照组单纯采用肝素盐水封管。结果 实验组可以明显降低导管的感染发生率（3.3% 比20%,х2=4.043，P=0.044）；实验组治疗前后凝血酶原时间 [（13.93±1.82）s 比（13.89±1.92）s，t=3.129，P=0.894]、血小板 [（190.59±49.65）×109 /L比（193.91±39.68）×109/L，t=0.393，P=0.617]、国际标准化比值[（1.20±0.20）s vs.（1.21±0.15）s，t=0.619，P=0.751]、活化的部分凝血活酶时间[（33.85±6.51）s 比（33.99±7.12）s，t=0.297，P=0.814]、纤维蛋白原[（2.98±0.78）g/L 比（3.06±0.76）g/L，t=0.706，P=0.483]、凝血酶时间[（11.37±1.59）s 比（ 11.91±1.54）s，t=0.587，P=0.523]差异无统计学意义。结论 定期应用尿激酶联合肝素封管，对维持性血液透析患者长期导管能减少感染的发生率，对预防相关性菌血症安全有效。
Objective To research the influence of regularly urokinase and heparin sealed tube to the long-term hemodialysis catheter tube in prevention of infection, so as to find out the clinical significance of regular application of urokinase and heparin seal tube. Methods We selected 60 patients using right internal jugular vein long-term indwelling catheter with cuff as vascular access line maintenance hemodialysis during April 2014 - March 2015 in our hospital dialysis centers, and randomly divided them into two groups （the experimental group and control group, each group of 30 patients）. The experimental group with a catheter-locking regimen of urokinase and heparin once weekly ,with heparin used in the other sessions.; The control group only with a catheter-locking regimen of heparin. Results The experimental group can obviously reduce the incidence rate of catheter infection （3.3% vs 25%;х2=4.043,p=0.044）;In the experimental group before and after treatment ,there were no significant changes in PT[（13.93±1.82）s vs.13.89±1.92）s,t=3.129,P=0.894]、PLT[（190.59±49.65）×109 /L vs.（193.91±39.68）×109/L,t=0.393,P=0.617]、INR[（1.2±0.20 ）s vs.（1.21±0.15）s,t=0.619,P=0.751]、APTT [（33.85±6.51）s vs.（33.99±7.12）s,t=0.297,P=0.814]、FIB[（2.98±0.78）g/L vs. （3.06±0.76）g/L,t=0.706,P=0.483]and TT [（11.37±1.59 ）s vs .（11.91±1.54）s,t=0.587,P=0.523].Conclusion Regularly urokinase and heparin sealed tube to the long-term hemodialysis catheter tube can reduced the incidence of infection , It is safe and effective to prevention of catheter-related bacteremia.
出处
《中国血液净化》
2016年第6期341-343,共3页
Chinese Journal of Blood Purification
关键词
血液透析
尿激酶
导管
Hemodialysis
Urokinase
Catheter tube
