目的：探讨尿激酶联合低分子肝素封管和低分子肝素封管联合吲哚布芬片口服在血液透析患者长期留置中心静脉导管中的应用效果。方法：将42例血液透析中心长期静脉置管的患者分为对照组（低分子肝素封管,n=14）、研究组A（尿激酶联合低分子肝素封管,n=14）和研究组B（低分子肝素封管联合吲哚布芬片口服,n=14）;将研究组A或研究组B与对照组的导管通透性、凝血指标、导管不良事件发生率进行比较。结果：研究组A相较于对照组,血流量、尿素清除指数、检测凝血酶原时间（PT）、活化部分凝血活酶时间（APTT）和国际标准化比值（INR） 上升,静脉压和纤维蛋白原（FIB） 下降。研究组B相较于对照组,血流量、尿素清除指数、PT、APTT和INR 上升,静脉压和FIB 下降。对照组与研究组A或对照组与研究组B之间不良事件发生率存在显著差异。结论：低分子肝素联合尿激酶或吲哚布芬片,相较于单独使用低分子肝素,在长期留置中心静脉导管的患者中,可保障透析的正常进行,降低凝血发生风险,应用价值高。
Abstract
Objective This study aimed to investigate the effect of low molecular weight heparin combined with urokinase or low molecular weight heparin combined with oral Indobufen in the sealing of central venous catheter in hemodialysis patients. Methods A total of 42 hemodialysis patients with central venous catheterization were divided into the control group (low molecular weight heparin, n=14), research group A (low molecular weight heparin combined with urokinase, n=14), and research group B (low molecular weight heparin combined with oral Indobufen, n=14). The catheter permeability, coagulation index, and the incidence of catheter adverse events were compared between the control group and research group A/B. Results Compared with the control group, the research group A was present with higher blood flow, urea clearance index, PT, APTT, and INR, and lower venous pressure and FIB. Compared with the control group, the research group B was present with higher blood flow, urea clearance index, PT, APTT, and INR, and lower venous pressure and FIB. There is a significant difference in the incidence of adverse events between the control group and study group A or between the control group and study group B. Conclusion The strategy of low molecular weight heparin combined with urokinase or low molecular weight heparin combined with oral Indobufen was effective in the sealing of central venous catheter in hemodialysis patients.
关键词
低分子肝素 /
尿激酶 /
吲哚布芬 /
血液透析 /
中心静脉导管
Key words
low molecular weight heparin /
urokinase /
indobufen /
hemodialysis /
central venous catheter
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