疏血通对肢体动静脉内瘘的保护应用

The Value of Shuxuetong Protect Arteriovenous Fistulas

目的:探讨疏血通注射液促进肢体动静脉内瘘(AVF)术后成熟的疗效及治疗AVF血栓性阻塞的效果。方法:用疏血通注射液和香丹注射液于AVF手术后预防性治疗各50例,用疏血通注射液和尿激酶治疗AVF阻塞各20例,每日1次,7d为1疗程;对比AVF成熟情况、复通效果、透析时能达到的最大血流量及用药前后血液流变学改变。结果:疏血通促进AVF成熟良好率显著高于香丹(χ2=4.336,P<0.05)。疏血通与尿激酶对内瘘部分阻塞的复通效果相当,但对完全阻塞无效。疏血通和尿激酶治疗后血浆黏度值和纤维蛋白原均显著下降(P<0.01);而香丹注射液虽能改善血浆黏度值和红细胞聚集指数,但对纤维蛋白原无影响(P>0.05)。结论:疏血通注射液能更好地促进肢体动静脉内瘘术后血管通路成熟,并能替代出血风险较大的尿激酶治疗AVF血栓形成致血管部分阻塞,可作为维护HD血管通路的常规治疗用药。

Objective：To investigate the effect of Shuxuetong in promoting forearm arteriovenous fistulas（AVF） mature, and thrombolysis effect on AVF emphraxis. Methods： One hundred patients after AVF operation were divided into Shuxuetong group and Xiangdan group, accepted Shuxuetong injection or Xiangdan injection prophylactic treatment for a week. Forty patients of AVF emphraxis were divided into Shuxuetong group and Urokinase group, accepted Shuxuetong injection or Urokinase for a week. AVF mature states,AVF recovered effect and maximum blood flow in hemodialysis were compared. Results： Shuxuetong made AVF mature better than Xiangdan （ X2 4. 336, P 〈 0.05）. Shuxuetong and Urokinase have similar effect on thrombolysis in AVF partial emphraxis, but no effect on complete AVF emphraxis. Plasma viscosity and fibrinogen were significantly descend（P〈 0.01） in both Shuxuetong group and Urokinase group, but no fibrinogen changed in Xiangdan group（P 〉0.05）. Conclusion： Shuxuetong can promote AVF vascular access preferably utilized. Shuxuetong can substitute Urokinase to solve AVF partial emphraxis by thrombopoiesis in vascular access. It can become a conventional therapy for protecting vascular access with less adverse effects.