Abstract：Objective To observe the effect of early urokinase sealing in preventing the formation of catheter fibrin sheath in long-term hemodialysis patients. Methods From February 2021 to February 2022,46 patients were selected for regular hemodialysis treatment in the hemodialysis room and nephrology department of our hospital. The patients were divided into two groups. In the urokinase group,23 patients began to receive urokinase tube sealing treatment at the time of the first dialysis treatment,while in the conventional group,23 patients only received conventional heparin tube sealing treatment at the time of the first dialysis treatment,and urokinase therapy was started only after the patient's catheter was dysfunctional. The occurrence of catheter dysfunction,the change of coagulation function index before and after treatment,the change of catheter blood flow and venous pressure during treatment and the occurrence of adverse reactions were compared between the two groups. Results The occurrence of catheter dysfunction in the urokinase group was much lower than that in the conventional group,and the average time of the first occurrence of catheter dysfunction in the urokinase group was later than that in the conventional group. At 6 months of dialysis,there was no significant difference in APTT,TT and Fib levels between the two groups,but the average PT time of the urokinase group was significantly longer than that of the conventional group. There was no significant difference in the mean catheter blood flow and venous pressure between the two groups at 1 month of dialysis. At 3 and 6 months of dialysis,the average blood flow in the urokinase group was significantly higher than that in the conventional group,while the venous pressure was significantly lower than that in the conventional group. Neither urokinase group nor routine group had any serious adverse reactions that needed to stop treatment,no gastrointestinal bleeding,serious liver injury and other drug toxicity. Conclusion In patients who need long-term catheterization for hemodialysis treatment,early urokinase sealing measures can better prevent the formation of fibrin sheath in the catheter,prolong the service life of the catheter,and have high safety.
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2024, Vol. 21 
