前列地尔联合贝前列素钠序贯疗法在终末期肾脏病建立动静脉内瘘成熟中的作用

Effect of alprostadil combined with beraprost sodium sequential therapy in the establishment of arteriovenous fistula in end stage renal disease

目的前列地尔联合贝前列素钠序贯疗法在终末期肾脏病(ESRD)建立动静脉内瘘成熟中的作用。方法选取2018年10月至2019年10月南京医科大学附属逸夫医院诊断为ESRD行维持性血液透析并需要建立标准自体动静脉内瘘患者80例,根据治疗方式不同分为治疗组(n=35)和对照组(n=45)。比较治疗第1天和第4天凝血功能;比较术后第1周和第4周两组患者动静脉内瘘成功率和相应指标;术后4周开始统计内瘘成熟时间和术后4周首次透析流量。术后6个月彩色多普勒超声评估内瘘成熟及并发症情况。结果两组患者治疗第1天和第4天凝血功能组间比较,差异无统计学意义;治疗组患者内瘘成熟时间为(32.9±4.7)d低于对照组患者(48.1±8.5)d,差异有统计学意义(P<0.05);术后4周,治疗组患者内瘘成功率高于对照组患者,差异无统计学意义;治疗组患者术后1周和4周的内瘘流量均高于对照组患者;治疗组患者术后4周头静脉内径宽于对照组患者,首次透析流量多于对照组患者,差异有统计学意义(P<0.05);术后6个月,治疗组患者内瘘成熟率高于对照组患者;并发症发生率低于对照组患者,差异无统计学意义。结论前列地尔联合贝前列素钠片序贯治疗能提高内瘘成功率,提高内瘘血流量,减少内瘘成熟时间。

Objective The effect of alprostadil combined with beraprost sodium sequential therapy in the establishment of arteriovenous fistula in end stage renal disease(ESRD).Method From October 2018 to October 2019,80 patients with ESRD undergoing maintenance hemodialysis and requiring establishment of standard arteriovenous fistula were selected from Sir Run Run Hospital,Nanjing Medical University and divided into treatment group(n=35)and control group(n=45)according to different treatment methods.The coagulation function was compared on the first day and the fourth day of treatment;the success rate and corresponding indicators of arteriovenous fistula were compared between the two groups at the first week and the fourth week after operation;the mature time of internal fistula and the first dialysis flow rate at 4 weeks after operation were counted.The maturity and complications of internal fistula were evaluated by color Doppler ultrasound 6 months after operation.Result There was no significant difference in coagulation function between the two groups on the first day and the fourth day of treatment;the mature time of internal fistula in the treatment group was(32.9±4.7)d,which was lower than that of the control group(48.1±8.5)d,the difference was statistically significant(P<0.05);4 weeks after operation,the success rate of internal fistula in the treatment group was higher than that in the control group,the difference was not statistically significant;the treatment group was 1 week and 4 weeks after operation The internal fistula flow of the treatment group was higher than that of the control group;the diameter of cephalic vein in the treatment group was wider than that in the control group at 4 weeks after operation,and the first dialysis flow was more than that in the control group,the difference was statistically significant(P>0.05);after 6 months,the maturity rate of internal fistula in the treatment group was higher than that in the control group;the incidence of complications was lower than that in the control group,the difference was not statistically significant.Conclusion Alprostadil combined with beraprost sodium tablets can improve the success rate of internal fistula,increase the blood flow of internal fistula and reduce the mature time of internal fistula.