两种不同的尿激酶溶栓方法对中心静脉永久性导管内血栓的疗效研究

Study of the Effects of Two Different Thrombolytic Methods Treated with the Thrombus in the Permanent Central Venous Catheters by Urokinase

目的:比较使用尿激酶持续泵入法与美国肾脏病基金会肾脏病预后质量倡议(Kidney disease outcomes quality initia-tive,K/DOQI)指南推荐的方法对中心静脉永久性导管血栓的治疗效果。方法:对66例临床诊断导管内血栓形成病例进行随机对照临床研究,其中治疗组33例,对照组33例,治疗组使用1000单位/ml尿激酶溶液100ml以50ml/小时持续泵入;对照组采用5000单位/ml尿激酶溶液2ml进行溶栓治疗,比较两种溶栓方法对中心静脉永久导管血栓的治疗效果及副作用。结果:治疗组溶栓后通畅率93.9%,对照组溶栓后通畅率90.9%,两组溶栓后通畅率差异无统计学意义。溶栓成功半月后,治疗组通畅率84.8%,对照组通畅率60.6%,溶栓成功一月后,治疗组通畅率81.8%,对照组通畅率54.5%,两组患者再次形成血栓的比例差异有统计学意义。两种不同溶栓治疗方案对患者凝血功能无明显影响。结论:尿激酶持续泵入法与常规溶栓法比较,其治疗成功率高,复发率低,无明显副作用及治疗并发症。

Objectives. To compare with the treatment effects of two thrombolytic methods treated with the thrombus in the permanent central venous catheters by urokinase, which one is continouse-pumping tech- nique,and the other is recommend by the K/DOQI guidelines of American Kidney Disease Foundation. Meth- ods. Sixty-six cases clinically diagnosed with thrombosis in catheters were involved in this randomized con- trolled clinical study. Thirty-three cases were involved in the treatment group, and the other 33 cases were in- volved in the control group. The treatment group apply with a technique of continouse-pumping with a 100 ml urokinase solution in a concentrention of 1000u/ml, and the control group treated with the thrombus with a 2 ml urokinase solution in a concentrention of 5000u/ml. Compare with the treatment effects and side effects of the two thrombolytic methods treated with the thrombus in the permanent central venous catheters. Results. The perforation rates of post-thrombosis of the treatment group is 93. 9%, and the control group is 90. 9%, the difference of the two groups has no statistic significance. After half a month, the treatment group is 84. 8%, and the control group is 60. 6%, while after a month, the treatment group is 69. 7%, and the control group is 42. 4%, the proportions of re-thrombosis have a significant statistic difference. The two different thrombolytic methods have no significant effects on the patient＇s coagulations. Conclusions. Compared with the conventional thrombolytic method, the continouse-pumping technique have high cure rates and low re- lapse rates,with no significant side effects and complications.