远红外线理疗联合氯吡格雷对血液透析患者自体动静脉内瘘血栓形成的影响

Effect of far-infrared therapy combined with clopidogrel on thrombosis of autologous arteriovenous fistula in hemodialysis patients

目的探讨远红外线理疗联合氯吡格雷对血液透析患者自体动静脉内瘘血栓形成的影响。方法选取2017年6月至2017年12月在本院血透中心行血液透析治疗的66例患者,按随机数字表法分为联合组、氯吡格雷组和对照组,每组22例。联合组给予远红外线理疗联合氯吡格雷治疗;氯吡格雷组给予口服氯吡格雷治疗;对照组不给予远红外线及口服氯吡格雷治疗。结果随访6个月后,联合组、氯吡格雷组及对照组患者治疗后的内瘘通畅率分别为90.91%(20/22)、77.27%(17/22)、59.09%(13/22),差异有统计学意义(P<0.05)。联合组和氯吡格雷组治疗后的血流量高于治疗前,差异有统计学意义(P<0.05)。对照组治疗前后的血流量比较,差异无统计学意义(P>0.05)。联合组患者治疗后的血红蛋白、血浆白蛋白、尿素清除指数均高于治疗前,而超敏C-反应蛋白低于治疗前,差异有统计学意义(P<0.05)。氯吡格雷组治疗后的血浆白蛋白低于治疗前,差异有统计学意义(P<0.05)。对照组患者治疗后的血浆白蛋白、尿素清除指数低于治疗前,差异均有统计学意义(P<0.05)。结论远红外线理疗联合氯吡格雷对预防自体动静脉内瘘血栓形成有良好的疗效。

Objective To investigate the clinical effect of far-infrared therapy combined with clopidogrel on thrombosis of autogenous arteriovenous fistula(AVF).Methods A total of 66 patients who underwent hemodialysis in the hemodialysis center of our hospital from June 2017 to December 2017 were selected and divided into combined group,clopidogrel group and control group according to random number table method,with 22 patients in each group.Patients in the combined group were given the therapy of far-infrared and clopidogrel,while in the clopidogrel group were only treated with clopidogrel.The control group was not treated with far infrared or clopidogrel.After 6 months follow-up,blood flow changes and the incidence of fistula thrombosis were compared in two groups.Results At the end of follow-up,the patency rate of fistula in the combined group,clopidogrel group and control group were 90.91%(20/22),77.21%(17/22)and 59.09%(13/22),respectively(P<0.05).The blood flow of patients in combined group and clopidogrel group after treatment were respectively significantly higher than that before treatment(P<0.05).In the control group,there was no significant difference in blood flow before and after treatment(P>0.05).The index of Hb,plasma albumin and Kt/V in the combined group was significantly higher than that before treatment,while hs-CRP was significantly lower(P<0.05).The plasma albumin was significantly lower in clopidogrel group after treatment(F<0.05).The index of serum albumin and Kt/V in the control group were lower than that before treatment(P<0.05).Conclusions Therapy of far-infrared combined with clopidogrel may protect AVF via reducing thrombosis.