基于活血通瘘方局部湿敷改善维持性血液透析患者内瘘功能的效果

Analysis on the efficacy of local wet compress of Huoxue Tonglou Recipe on improving fistula function in maintenance hemodialysis patients

目的分析活血通瘘方局部湿敷法应用于行自体动静脉瘘(AVF)维持性血液透析患者中的临床价值。方法选取海门区中医院2017年10月至2019年10月收治的80例维持性血液透析的患者,随机分为观察组(接受活血通瘘方局部湿敷联合西药)和对照组(接受西药与温水湿敷),每组各40例。比较两组头静脉血流量、头静脉内径、内瘘成熟时间、可穿刺长度、吻合口血流量、吻合口内径、并发症。结果观察组的头静脉/吻合口血流量明显多于对照组(P<0.05);观察组的头静脉/吻合口内径明显大于对照组(P<0.05);观察组的内瘘成熟时间明显短,可穿刺长度明显长于对照组(P<0.05);观察组的并发症总发生率为7.50%,低于对照组的27.50%(P<0.05)。结论活血通瘘方应用于血液透析实施AVF的患者中,可以明显改善血液流变学,改善内瘘管径、流量,减少并发症的发生。

Objective To analyze the clinical value of local wet compress of Huoxue Tonglou Recipe in patients undergoing maintenance hemodialysis with autogenous arteriovenous fistula(AVF).Methods A total of 80 maintenance hemodialysis patients admitted to the Haimen Hospital of Traditional Chinese Medicine from October 2017 to October 2019 were selected as the study objects.They were randomly divided into the observation group which receiving local wet compress of Huoxue Tonglou Recipe combined with western medicine and the control group which receiving wet compress with western medicine and warm water,with 40 cases in each group.The corresponding indicators such as cephalic vein blood flow,cephalic vein diameter,maturation time of fistula,puncturable length,anastomotic blood flow,anastomotic internal diameter and complications of the two groups were compared.Results The cephalic vein and anastomotic blood flow in the observation group was significantly more than that in the control group(P<0.05).The cephalic vein and anastomotic internal diameters in the observation group were significantly larger than those in the control group(P<0.05).The maturation time of fistula in the observation group was significantly shorter than that in the control group,and the puncturable length in the observation group was significantly longer than that in the control group(P<0.05).The total incidence of complications in the observation group(7.50%)was lower than that in the control group(27.50%)(P<0.05).Conclusion The application of Huoxue Tonglou Recipe in maintenance hemodialysis patients with AVF can significantly improve hemorrheology indices,improve the diameter and flow of fistula,and reduce the occurrence of complications.