靶向注射尿激酶对血透患者动静脉内瘘血栓形成的治疗作用

Thrombolytie Effects of Target-injected Urokinase on Hemodialysis Patients with Autologous Arteriovenous Fistulae

目的观察尿激酶靶向溶栓治疗对血液透析患者动静脉内瘘血栓形成的疗效。方法18例患者于瘘管血栓形成的近心端微泵注射尿激酶25～40万u／小时，平均30万u，观察治疗前后血管波动、血管杂音以及不良反应、血压和肝肾功能.结果在总共进行的21例次溶栓治疗中，总成功率83．4％（18／21），一次成功率为94．4％（17／18）。溶栓成功主要于血栓形成时间和血压关系密切。结论微泵靶向性注射小剂量尿激酶治疗血液透析患者动静脉内瘘血栓形成的疗效确切，且操作简单，不良反应少，值得临床推广。

Objective To observe the thrombolytic effects of target-injected urokinase on thrombosed hemodialysis patients with autologous arteriovenous fistulae. Yetbods 18 patients were target-injected near thrombosed fistulae 250000～400000u per hour by an intravenous micropump, the souffle and pulsade of blood vessels, hepatic and renal function, blood pressure and side effects were examined before and after injection. Results Totally, 18 injections in 21 （83.4%） were successful, the one-time reopen rate was 94.4% （17/18） with no significant side effects. Whether reopen of thrombosed fistulae mainly depended on duration of thrombosis and blood pressure. Conclusion Taget-injected urokinase by an intravenous micro-pump could effectively reopen thrombosed fistulae of patients with hemodialysis, should be recommended to widely use in clinic treatment because of its powerful effectiveness, ease-control and few sideeffects.