摘要
目的观察持续静脉滴注大剂量尿激酶对血液透析（HD）长期中心静脉留置导管（CVC）血栓的治疗作用。方法对78例长期CVC导管内血栓形成的HD患者的临床资料进行前瞻性随机对照研究，其中治疗组45例，对照组33例。治疗组使用尿激酶125000U／次，持续滴注6h，对照组使用5000U／ml进行24h封管溶栓治疗，比较两种溶栓治疗方法对长期CVC血栓形成的治疗效果以及不良反应。结果治疗组动脉端溶栓成功率为88．2％，静脉端成功率为95．7％，总成功率为91．2％；对照组动脉端溶栓成功率为76．0％，静脉端成功率为75．0％，总成功率为75．6％；治疗组溶栓总成功率明显优于对照组（P〈0．05）。溶栓治疗成功后观察随访3个月，治疗组患者导管功能不良发生率（11．5％）显著低于对照组（35．5％）。结论持续滴注大剂量尿激酶较尿激酶封管治疗导管血栓疗效好，导管功能不良发生率较低，值得推广。
Objective To observe the effect of high dose urokinase continuous infusion treatment on thrombosis in permanent central venous catheters （CVC） for hemodialysis. Methods A prospective randomized controlled study was performed, 78 hemodialysis patients with thrombosis caused by CVC were studied, Among them, 45 patients were treated with 125 000 U urokinase continuous infusion for 6 h（treatment group） , and 33 patients were treated with 5000 U/ml urokinase intra-catheter dwelling-lock thrombolysis regimen （control group）. Lumen patency, side effects and catheter thrombus reoccurrence were assessed and compared between the two groups after treatment. Results In treatment group, thrombolytic successful rate of arterial end was 88.2% , that of venous end was 95.7% , and the total successful rate was 91.2% ; in control group, thrombolytic successful rate of arterial end was 76.0% ,that of venous end was successful rate was 75.0%, and the total 75.6% ; The total successful rate of thrombolysis was significantly higher in treatment group than that in controlgroup （ P 〈 0.05 ）. After the success of thrombolytic therapy, followed-up for 3 months, the incidence of catheter malfunction in treatment group （11.5%） was significantly lower than that in control group （35.5%）. Conclusions The effect of high dose urokinase continuous infusion thrombolysis technique is better than intra-catheter dwelling-lock thrombolysis regimen on permanent CVC for HD. And the incidence of catheter malfunction was lower, is worthy to be popularized.
出处
《中国实用医刊》
2012年第3期35-37,共3页
Chinese Journal of Practical Medicine
关键词
血液透析
静脉留置导管
血栓形成
尿激酶
Hemodialysis
Intravenous indwelling catheter
Thrombosis
Urokinase
