45例中心静脉双腔导管血栓形成尿激酶溶栓治疗的体会

The thrombolytic therapy of Urokinase in 45 patients with central venous double-lumen catheter thrombosis

目的:探讨中心静脉双腔导管血栓形成治疗的有效办法。方法:45例肾功能衰竭留置中心静脉双腔导管的患者,经确定采用中心静脉导管栓塞后,先用尿激酶10万U+生理盐水10 ml配成浓度为1万U/ml尿激酶溶液,予以1 ml注射器于血栓形成侧导管内缓慢注射尿激酶溶液1.0 ml,10 min后再注射尿激酶溶液0.3～0.5 ml,再过10 min注射尿激酶溶液0.3～0.5 ml,保留10 min后用10 ml注射器抽吸导管,导管通畅即接生理盐水点滴数分钟,若血透导管不通可重复上述步骤。结果:45例采用此法治疗的患者中,43例导管再通,2例因导管栓塞时间大于3 d,溶栓治疗失败,改其他部位重新置管。结论:早期应用此法溶栓治疗导管再通率高,减少患者再次置管的痛苦及经济负担。

Objective： To investigate the effective method of the double-lumen central venous catheter thrombosis.Methods： 45 cases of renal failure,indwelling central venous double-lumen catheter in patients with central venous catheter thrombosis was established,the first with Urokinase 100 000 U＋saline 10 ml dubbed concentration 10 000 U/ml Urokinase solution to 1 ml syringe in thrombosis slow side of intraductal injection of Urokinase solution 1.0 ml,10 min after the injection of Urokinase solution of 0.3～0.5 ml,another 10 min injection of Urokinase solution 0.3～0.5 ml,after 10 min with 10 ml syringe to retain suction catheter,immediately following saline drip a few minutes,if the dialysis catheter barrier can repeat these steps.Results： 45 cases of patients treated with this method in 43 cases of ductal patency,catheter embolization in 2 cases because of time greater than 3 days,thrombolytic treatment failure,changed other parts of the re-tube.Conclusion： The early treatment of catheter method has been applied thrombolytic recanalization rate and reduce the suffering of patients with re-catheterization and economic burden.