规律性微量泵入尿激酶溶栓治疗对维持性血液透析患者的效果.docVIP

规律性微量泵入尿激酶溶栓治疗对维持性血液透析患者的效果 　　[摘要]目的 探?规律性微量泵入尿激酶溶栓治疗对维持性血液透析患者的效果。方法 选取2015年12月～2017年3月在我院血液透析中心36例带绦纶套双腔导管且留置时间3个月的维持性血液透析患者，按照随机抽签法分为观察组（微量泵入尿激酶溶栓治疗）和对照组（定时保留式尿激酶溶栓法治疗），每组18例。观察组使用尿激酶125 000 U/次+NS100 ml微量泵入，每2周1次，持续滴注1 h。对照组使用125 000 U/次+NS12 ml分3次进行推注封管溶栓治疗，每2周1次，每次1 h，两组均治疗3个月。比较两组患者治疗前后血流量、静脉压及KT/V值变化情况；记录两组患者cuff管血栓形成、导管感染及导管功能不良等反应情况。结果 治疗后，观察组静脉压（68.0±30.5）mmHg显著低于对照组（162.0±37.5）mmHg，差异有统计学意义（P0.05）。结论 规律性微量泵入尿激酶溶栓治疗，可有效地维持带cuff导管的功能，延长导管使用时间，提高透析效率，是一种安全有效的治疗手段。 　　[关键词]血液透析；顽固性高血压；可调钠曲线透析；低钙透析液 　　[中图分类号] R692.5 [文献标识码] A [文章编号] 1674-4721（2017）10（c）-0046-04 　　Effect of regular micro-pumped urokinase as a thrombolytic therapy on maintenance hemodialysis patients 　　ZHANG Min-qiu CHENG Jing▲ 　　Department of Hemodialysis，the First Affiliated Hospital of Nanchang University，Jiangxi Province，Nanchang 330006，China 　　[Abstract]Objective To investigate the effect of regular micro-pumped urokinase as a thrombolytic therapy on maintenance hemodialysis （MHD） patients.Methods From December 2015 to March 2017，36 MHD patients who were indwelled with dual-lumen catheter with a Dacron cuff for over 3 months in hemodialysis center in our hospital were selected.By random lot-drawing，they were evenly divided into observation group（micro-pumped urokinase as a thrombolytic therapy） and control group （retained urokinase at regular time as a thrombolytic therapy），18 cases in each group In the observation group，micro-pumped urokinase （125 000 U each time ） and NS（100 ml） for one continuous hour of dripping，once every two weeks，while in the control group，urokinase （125 000 U each time） and NS （12 ml） were injected into a sealed tube for thrombolytic treatment at three times，one hour once，and once every two weeks.The courses of treatment lasted for 3 months.The blood flow volume，and the changes of venous pressure and KT/V before and after therapy were observed and compared in the two groups.The cuff tube thrombosis，tube infection，and catheter dysfunction were recorded in bot