摘要
目的观察肝素封管联合TCC静脉滴注尿激酶在防治导管功能不良和导管相关血流感染的作用方法选择以TCC为血管通路的血液透析患者,根据TCC抗凝方案的不同,将患者随机分为三组,A组为肝素封管,B组为尿激酶封管+肝素封管,C组为尿激酶静脉滴注+肝素封管。观察各组患者置管1个月和12个月时Hb、ALB、炎症因子、凝血功能、TCC导管功能及导管感染。结果C组ALB和Hb水平高于A组和B组(P<0.05);各组凝血功能比较差异无统计学意义(P>0.05);各组较,C组炎症因子低于A组和B组(P<0.05);C组导管的血流量、静脉压及Kt/V值均优于A组和B组(P<0.05);⑤C组CRBSI、因感染更换导管和尿毒症脑病病例均为0,A组分别发生4例(25%)、4例(25%),和5例(31.25%),两组比较?<0.05。结论肝素封管联合定期通过TCC静脉滴注尿激酶可显著减少导管功能不良和导管相关血流感染的发生,且对血红蛋白、血白蛋白和炎症状态具有改善作用。
Objective To observe the effect of heparin sealing tube combined with regular intravenous drip of urokinase through TCC in the prevention and treatment of catheter-related bloodstream infection.Methods According to the different anticoagulant schemes,the patients were randomly divided into three groups:group A with pure heparin,group B with urokinase and heparin,and group C with intravenous drip of urokinase and heparin.The clinical events such as Hb,ALB,inflammatory factors,coagulation function,TCC catheter function and catheter infection were observed at 1 and 12 months after catheterizarion.Results The levels of ALB and Hb in group C were higher than those in group A and group B(P<0.05);there was no significant difference in coagulation function among groups(P>0.05);the inflammatory factors in group C were the lowest(P<0.05);④the catheter blood flow,venous pressure and kt/V value in group C were better than those in group A and group B(P<0.05);CRBSI,catheter replacement due to infection and uremic encephalopathy were 0 in group C,4 cases(25%)in group A,and 5 cases(31.25%)in group a respectively,P<0.05.Conclusion Heparin sealing combined with regular infusion of urokinase through TCC can significantly reduce the incidence of catheter dysfunction and catheter-related bloodstream infection,and improve hemoglobin,albumin and inflammatory.
出处
《浙江临床医学》
2021年第7期1043-1045,共3页
Zhejiang Clinical Medical Journal
关键词
带隧道和涤纶套透析导管
导管功能不良
导管相关血流感染
封管液
Tunnel-cuffed catheter
Catheter dysfunction
Catheter-related bloodstream infection
Catheter lock solution
