华法林在预防血液透析长期留置导管血栓形成中的作用

Anticoagulation therapy of warfarin for the prevention of hemodialysis tunneled cuffed catheters thrombosis

对于无法建立动静脉内瘘的维持性血液透析患者,长期留置的中心静脉导管(TCC)是其重要的血管通路,而导管血栓形成已经成为严重影响TCC使用寿命的主要并发症之一。华法林是一种传统的抗凝药物,临床上多用于心房纤颤、肺栓塞及下肢静脉血栓。大量研究证明,使用TCC进行血液透析的尿毒症患者,在严密监测国际标准化比值(INR)的情况下,应用华法林可以有效预防TCC的血栓和纤维鞘形成,延长导管的使用寿命。本文综述华法林预防血液透析长期留置导管血栓形成的作用。

The tunneled cuffed catheter （TCC） is a vital vascular access for the patients who are undergoing hemodialysis or can＇t establish arterio-venous fistula. The luminal obstructive thrombus in the catheters has become a major complication that badly influences the service life of the TCC. Warfarin is a conventional anticoagulant and usually used for atrial fibrillation, pulmonary embolism and veins of lower extremity thrombosis. Under the closly monitoring of INR, the effective of warfarin in preventation the thrombosis and malfunction of TCC had been proved for many studies, and it could be prolong the service life of the catheter. This paper reviews the prevention of warfarin on thrombosis of TCC.