三七合剂联合微波防治动静脉内瘘并发症的临床研究

Clinical research on notoginseng mixture combined with microwave in prevention and treatment of complications in arteriovenous fistula

[目的]观察三七合剂联合微波理疗对延长动静脉内瘘寿命的临床效果。[方法]选取2013年6月—2014年12月在肾病内科行血液透析且符合纳入标准的病人120例,将其随机分成3组:A组采用50%硫酸镁溶液湿敷治疗,B组使用喜疗妥乳膏外擦治疗,C组采用三七合剂联合微波疗法治疗。评价病人治疗前和治疗后24h疼痛缓解、皮下血肿消退情况;随访病人规律治疗2个月,追踪发生动静脉内瘘血管狭窄及闭塞状况,比较透析前后3组病人血液中炎性因子水平。[结果]治疗后24h视觉模拟评分法(VAS)评分及疼痛消退平均时间比较,差异有统计学意义(P<0.05);C组治疗后24h血肿直径较治疗前及A组、B两组显著减小,差异有统计学意义(P<0.05);C组动静脉内瘘血管狭窄发生率明显低于A组和B组,差异有统计学意义(P<0.05);3组病人透析后血液中炎性因子水平比较,C组明显低于其他两组(P<0.05)。[结论]三七合剂联合微波理疗能有效降低动静脉内瘘并发症,可延长动静脉内瘘病人寿命。

Objective：To observe the clinical effect of notoginseng mixture combined with microwave physiother-apy for prolonging the life of arteriovenous fistula patients .Methods：A total of 120 patients were selected ,who have had hemodialysis in department of nephrology from June 2013 to December 2014 and met the inclusion cri-terias .The patients were randomly divided into three groups ：group A received the treatment of 50% magnesi-um sulfate wet compress ,group B received the treatment of Hirudoid cream rub ,group C received the treatment of notoginseng mixture combined with microwave .Then the easement of pain and subcutaneous hematoma sub-side situation were evaluated before treatment and 24 h after treatment ;and the patients were followed up who had regular treatment for 2 months ,the vascular stenosis and occlusion of the arteriovenous fistula were tracked ,the levels of inflammatory factors in the blood were compared among the 3 groups before and after dial-ysis .Results：24 h after treatment ,the differences of visual analogy score（VAS） scores and the average time of pain subside were statistically significant （P〈0 .05）;24 h after treatment ,the hematoma diameter in group C significantly decreased when compared with that before treatment and that in group A ,B ,the differences were statistically significant （P〈0 .05）;the incidence of arteriovenous fistula vascular stenosis in group C was signifi-cantly lower than that in group A and group B ,the differences were statistically significant （P〈0 .05）;in the comparison of inflammatory factors level in the blood among the 3 groups ,that in group C was significantly lower than that in the other two groups（P〈0 .05） .Conclusion：The notoginseng mixture combined with micro-wave therapy could effectively reduce the complications of arteriovenous fistula ,and prolong the life of patients with arteriovenous fistula .