尿激酶联合肝素封管预防血透患者长期留置导管功能不良的效果分析

Analysis on the Effect of Urokinase Combined with Heparin for Tube Sealing in Prevention of Long-Term Indwelling Catheter Dysfunction in Hemodialysis Patients

目的分析尿激酶联合肝素封管预防血液透析患者长期留置导管功能不良的临床效果。方法选取2020年6月至2021年7月在我院使用留置导管行血液透析的60例患者,随机分成两组各30例。对照组采用肝素封管,观察组采用尿激酶联合肝素封管。比较两组的导管堵塞率、溶栓再通率以及透析时的血流量、静脉压和尿素清除指数(Kt/V)。结果观察组的导管堵塞率显著低于对照组,溶栓再通率显著高于对照组(P<0.05)。末次透析时,两组的血流量、Kt/V均显著低于首次透析时,静脉压均显著高于首次透析时(P<0.05);与对照组相比,观察组末次透析时的血流量、Kt/V均显著更高,静脉压显著更低(P<0.05)。结论尿激酶联合肝素封管可有效预防血液透析患者长期留置导管功能不良,提高透析效果。

Objective To analyze the clinical effect of urokinase combined with heparin for tube sealing in prevention of long-term indwelling catheter dysfunction in hemodialysis patients.Methods 60 patients who underwent hemodialysis with indwelling catheter in our hospital from June 2020 to July 2021 were selected and randomly divided into two groups,with 30 cases in each group.The control group was sealed with heparin,and the observation group was sealed with urokinase combined with heparin.The catheter obstruction rate,thrombolytic recanalization rate,and blood flow,venous pressure and urea clearance index(Kt/V)during dialysis were compared between the two groups.Results The catheter obstruction rate of the observation group was significantly lower than that of the control group,and the thrombolytic recanalization rate was significantly higher than that of the control group(P<0.05).At the last dialysis,the blood flow and Kt/V of the two groups were significantly lower than those at the first dialysis,and the venous pressures were significantly higher than those at the first dialysis(P<0.05);Compared with the control group,the blood flow and Kt/V at the last dialysis of the observation group were significantly higher,and the venous pressure was significantly lower(P<0.05).Conclusions Urokinase combined with heparin for tube sealing can effectively prevent long-term indwelling catheter dysfunction in hemodialysis patients and improve dialysis effect.