不同剂量尿激酶治疗动静脉内瘘血栓形成的应用研究

Application of different doses of urokinase in the treatment of thrombosis of arteriovenous internal fistula

目的 探讨不同剂量尿激酶治疗动脉内瘘血栓形成的有效性和安全性.方法将2011年1月至2018年9月在本院肾内科行维持性血液透析、自体动静脉内瘘血栓形成的118例患者,按尿激酶溶栓用量的不同分为A组(10万单位尿激酶)、B组(50万单位尿激酶)、C组(100万单位尿激酶).比较三组间患者溶栓成功率、并发症情况.结果 C组溶栓成功率明显优于A、B组(P<0. 05),而三组间并发症的发生率差异无统计学意义(P>0. 05).结论 给予100万单位尿激酶能够明显提高内瘘溶栓成功率,而并发症的发生率与10万、50万单位无明显差异,延长了内瘘使用寿命,同时不增加出血并发症的风险,有效提高透析质量.

Objective To investigate the efficacy and safety of different doses of urokinase in the treatment of arteriovenous fistula thrombosis.Methods From January 2011 to September 2018,118 patients underwent maintenance hemodialysis and autologous arteriovenous thrombosis in the department of nephrology of our hospital who were divided into three groups:group A(100000 units of urokinase),group B(500000 units of urokinase)and group C(1 million units of urokinase)according to the dosage of urokinase thrombolysis.We compared the success rate of thrombolysis between the three groups and the incidence of thrombolysis complications between group B and group C.Results The success rate of thrombolysis in group C was significantly better than that in group A and B(P<0.05),while there was no significant difference in the incidence rate of complications between groups C and B(P>0.05).Conclusions One million units of urokinase can significantly improve the success rate of thrombolysis of arteriovenous fistula,while the incidence of complications is not significantly different from 500000 units,extending the service life of arteriovenous fistula in maintenance hemodialysis patients,without increasing the risk of bleeding complications,and effectively improving the quality of dialysis.