两种药物溶栓方法治疗动静脉内瘘栓塞的疗效分析.docVIP

两种药物溶栓方法治疗动静脉内瘘栓塞的疗效分析 　　[摘要] 目的 比较两种药物溶栓方法治疗动静脉内瘘栓塞的效果。 方法 以本院2007年5月～2013年5月进行动静脉内瘘血栓治疗的患者47例为研究对象，并分为对照组与实验组，分别采用单纯尿激酶与尿激酶联合低分子肝素钠、疏血通治疗方法，观察两组的治疗效果、血栓再通时间、凝血酶原时间（PT）、活化部分凝血活酶时间（APTT）及不良反应等。 结果 治疗后，实验组的血栓再通时间、PT及APTT明显低于对照组（P0.05）；实验组未出现任何不良反应，对照组中有3例出现不通的情况而转为手术进行取栓治疗。对照组再通率为58.33%，实验组为71.43%，两组差异有统计学意义（P0.05）。 结论 尿激酶联合低分子肝素钠、疏血通综合治疗动静脉内瘘栓塞的溶栓效果优于单纯用尿激酶溶栓的效果，再通率较高。 　　[关键词] 尿激酶；低分子肝素钠；疏血通；溶栓治疗；动静脉内瘘栓塞 　　[中图分类号] R459.5 [文献标识码] B [文章编号] 1674-4721（2013）11（a）-0162-02 　　Efficacy analysis of two thrombolytic therapies for embolism of arteriovenous fistula 　　YANG Dong ZHOU Feng XU Cai 　　Shenzhen TCM Hospital，Shenzhen 518033，China 　　[Abstract] Objective To compare the effect of two thrombolytic therapies for embolism of arteriovenous fistula.Methods 47 cases of patients with arteriovenous fistula treated in our hospital from May 2007 to May 2013 were selected as study object and assigned into control group and trial group，were received simple application of urokinase and urokinase combined with low molecular heparin sodium and Shuxuetong respectively.The curative effect，recanalization time of thrombus，PT，APTT，and adverse reactions in both groups were observed.Results After treatment，recanalization time of thrombus，PT，and APTT of trial group was shorter than that of contol group （P0.05）.The trial group had no any adverse reactions，3 cases in control group had occurred impassable circumstances and had been transferred for surgical treatment of removing thrombus.The rate of recanalization was 58.33% in control group，while 71.43% in trial group.Conclusion The thrombolytic effect of urokinase combined with low molecular heparin sodium and Shuxuetong is superior to that of urokinase alone，the former has higher rate of recanalization. 　　[Key words] Urokinase；Low molecular heparin sodium；Shuxuetong；Thrombolytic treatment；Embolism of arteriovenous fistula 　　血管内瘘是血透的一种通路方式，主要通过将动静脉结合以保障治疗时有充分的血液提供，是目前比较理想的一种血管通路[1]。但是容易产生血栓和狭窄两种并发症，而期间如果形成血栓，则会影响通路的功能，阻碍透析治疗的正常进行，须重建血