双向注射尿激酶治疗动静脉内瘘血栓的疗效分析

Analysis of curative effect by bidirectional injection of urokinase in the treatment of internal arteriovenous fistula thrombosis

目的探讨使用单向和双向注射尿激酶两种不同方式治疗血液透析患者动静脉内瘘血栓的临床疗效,为临床治疗提供参考。方法 56例血液透析并出现动静脉内瘘血栓的患者,随机分为A组和B组,各28例。A组分别在距离动静脉内瘘血栓约2 cm处的近心端和远心端双侧注射尿激酶溶栓,B组仅在距离动静脉内瘘血栓约2 cm处的近心端一侧注射尿激酶溶栓。比较两种不同治疗方式处理动静脉内瘘血栓的疗效。结果 A组较B组尿激酶使用剂量低,溶栓时间短,溶栓效果好,不良反应少,比较差异均具有统计学意义(P<0.05)。结论双向注射尿激酶溶栓法治疗血液透析患者动静脉内瘘血栓具有优势,值得临床探讨应用。

Objective To investigate clinical effects by unidirectional and bidirectional injection of urokinase in the treatment of internal arteriovenous fistula thrombosis in hemodialysis patients, and to provide reference for clinical treatment. Methods A total of 56 hemodialysis patients with internal arteriovenous fistula thrombosis were randomly divided into group A and group B, with 28 cases in each group. Group A received bidirectional injection of urokinase for thrombolysis at 2 cm proximal and telecentric parts of internal arteriovenous fistula thrombosis, and group B received unidirectional injection at 2 cm proximal part alone. Curative effects by the two difference measures were compared. Results Comparing with group B, group A had lower urokinase dosage, shorter thrombolysis time, better effect and less adverse reactions. Their differences all had statistical significance（P0.05）. Conclusion Bidirectional injection of urokinase for thrombolysis contains advantages in the treatment of internal arteriovenous fistula thrombosis in hemodialysis patients, and it is worth clinical investigation and application.