桂龙护瘘酊促进血透患者自体动静脉内瘘成熟的临床观察

A Clinical Observation of the Promoting Effect of Guilong Hulou Tincture on Maturation of Arteriovenous Fistula for Patients with Hemodialysis

目的:观察桂龙护瘘酊外涂促进维持性血透患者内瘘成熟的临床疗效。方法:收集2014年1月~2016年1月期间72例慢性肾功能衰竭CKD5期患者,随机分成对照组35例和观察组37例,对照组内瘘术后常规围手术期处理,术后行功能锻炼,观察组除上述常规处理外,行局部沿内瘘血管走形予桂龙护瘘酊外涂,每天3次,共8周。采用物理检查结合彩色多普勒超声方法评估两组患者术后血管条件(弹性、震颤)、静脉扩张平均内径、动脉阻力指数及血流量等指标,综合评价内瘘成熟。结果:内瘘术后8周观察组静脉扩张平均内径、动脉阻力指数明显优于对照组,差异有统计学意义(P<0.05);观察组血管条件(弹性、震颤)优于对照组,差异有统计学意义(P<0.05);两组血流量对比,差异无统计学意义(P>0.05)。结论:桂龙护瘘酊外涂能有效促进透析患者自体动静脉内瘘成熟,有效降低内瘘功能成熟不良,为提供高质量动静脉内瘘提供可能方法。

Objective To observe the clinical curative effect of Guilong Hulou Tincture on promoting the maturation of the arteriovenous fistula for MHD patients. Methods： 72 cases of patients with CKD5 from January2014 to Juanuary 2016 were randomly divided into a control group with 35 cases and an observation group with37 cases. The patients in the control group were given conventional perioperative treatment after the internal fistula operation and postoperative functional training,while the patients in the ovservation group were given Guilong Hulou Tincture along the the fistula vessel shape additionally,3 times a day for 8 weeks as a course. To evaluate the internal fistula maturation synthetically according to the infactors of postoperative vascular condition（ elasticity,tremor）,mean diameter of phlebectasis,arterial resistance index and blood flow volume assesed by the combination of physical examination and the ultrasonography. Results： 8 weeks after operation,the mean diameter of phlebectasis and arterial resistance index of the observation group were significantly better than those in the control group,with statistically significant difference（ P〈0.05）. The observation group showed better vascular condition（ elasticity,remor）. The difference was statistically significant（ P 〈0. 05）. The comparasion of the blood flow between the two groups was not statistically significant（ P〉0.05）. Conclusions： Guilong Hulou Tincture can effectively promote the maturation of arteriovenous fistula in hemodialysis patients,and reduce the unhealthy fistula maturity,which and provide feasible methods for the high quality arteriovenous fistulas.