三七粉和多磺酸基粘多糖联合微波理疗预防内瘘并发症的疗效观察

Clinical curative effect of notoginseng powder and mucopolysaccharide polysulfate cream combined with microwave therapy in preventing the complications of arteriovenous fistula

目的观察三七粉和多磺酸基粘多糖联合微波理疗对预防血液透析患者动静脉内瘘并发症的疗效。方法选取240例在我院采用动静脉内瘘接受维持性血液透析治疗的患者，按数字表法随机分为3组，每组各80例。三七粉联合微波组（A组），在血液透析结束后于瘘口及静脉血管处涂抹三七粉，同时联合微波理疗；多磺酸基粘多糖联合微波组（B组），在瘘口周围涂抹多磺酸基粘多糖，同时采用微波理疗；三七粉和多磺酸基粘多糖联合微波理疗组（C组），在A组治疗基础上，于治疗结束1h后再用多磺酸基粘多糖软膏外敷，同时加用微波理疗。3组患者的治疗均是每日一次，疗程14d，连续治疗2个疗程。观察3组患者内瘘在1年期间形成血栓、闭塞、血管硬化、感染以及出血的发生率。结果A组与B组比较，内瘘血管并发症的发生率无明显差异（P〉0．05）；C组内瘘发生血栓、闭塞、血管硬化、感染、出血等并发症的发生率明显低于另外两组（P〈0．05）。结论三七粉和多磺酸基粘多糖联合微波理疗能够有效预防动静脉内瘘相应并发症的发生。

Objective To observe the efficacy of notoginseng powder and mucopolysaccharide polysulfate cream combined with microwave therapy in preventing the complications of arteriovenous fistula in patients subject to maintenance hemodialysis （MHD）. Methods 240 cases of arteriovenous fistulas subject to MHD were randomly divided into three groups： notoginseng powder combined with microwave treatment group （group A） given notoginseng powder combined with microwave therapy a round the fistula and veins at the end of the hemodialysis was applied; mucopolysaccharide polysulfate cream combined with microwave therapy group （group B） given mucopolysaccharide polysulfate cream around the fistula combined with microwave treatment; notoginseng powder and mucopolysaecharide polysulfate cream combined with microwave treatment group （group C） given the external application of mucopotysaccharide polysulfate cream 1 h after notoginseng powder combined with microwave treatment. There were 80 cases in each group. The patients in three groups were treated once daily for 2 consecutive courses with 14 days in a treatment course. The incidence of thrombosis, occlusion, vascular sclerosis, infection and hemorrhage was observed in the arteriovenous fistula among the three groups during 1 year. Results There was no significant difference between group A and group B in the incidence of internal fistula vascular complications （P〉0. 05）. The incidence of fistula complications such as thrombosis, occlusion, vascular sclerosis, infection and hemorrhage in group C was significantly lower than in the rest two groups （P〈0. 05）. Conclusions Notoginseng powder and mucopoly-saccharide polysulfate cream combined with microwave therapy can effectively prevent the complications of arteriovenous fistulas.