中药护瘘贴在血液透析患者动静脉瘘功能成熟中的临床应用

Clinical application of traditional Chinese medicine fistula protection patch in the functional maturity of arteriovenous fistula in hemodialysis patients

目的 探讨中药护瘘贴在血液透析患者动静脉瘘(AVF)功能成熟中的临床疗效。方法 收集2021年1月至2022年4月于解放军联勤保障部队第九〇〇医院行血液透析的70例终末期肾功能衰竭患者的临床资料,根据是否接受中药护瘘贴治疗将其分为干预组(n=35)和对照组(n=35)。治疗前、治疗2个月后统计两组患者血流量、静脉内径,治疗2个月后比较两组患者AVF成熟时间、透析时泵控血流量、AVF相关并发症发生情况、心理状态评分、数字评分法(NRS)评分,记录两组患者首次通畅率、平均通畅时间。结果 治疗2个月后,两组患者血流量、静脉内径均高于本组治疗前,且干预组患者血流量、静脉内径均高于对照组患者,差异均有统计学意义(P﹤0.05)。治疗2个月后,干预组患者透析时泵控血流量高于对照组患者,AVF成熟时间短于对照组患者,差异均有统计学意义(P﹤0.05)。治疗2个月后,干预组患者NRS评分、心理状态评分均低于本组治疗前及对照组患者,差异均有统计学意义(P﹤0.05);治疗2个月后,对照组患者NRS评分低于本组治疗前,差异有统计学意义(P﹤0.05)。对照组患者AVF相关并发症总发生率为48.57%(17/35),略高于干预组患者的42.86%(15/35),但两组比较差异无统计学意义(P﹥0.05)。干预组患者首次通畅率高于对照组患者,首次通畅时间长于对照组患者,差异均有统计学意义(P﹤0.05)。结论 中药护瘘贴可有效提高血流量、静脉血管内径、透析时泵控血流量,缩短内瘘成熟时间,有效延长AVF的使用时间,降低内瘘相关并发症发生率,安全可靠,值得临床上推广应用。

Objective To investigate the clinical efficacy of traditional Chinese medicine fistula-protecting patch in the functional maturity of arteriovenous fistula(AVF)in hemodialysis patients.Method The clinical data of 70 patients with end-stage renal failure who underwent hemodialysis in the No.900 Hospital of the Joint Logistics Support Force of the Chinese People's Liberation Army from January 2021 to April 2022 were collected.They were divided into intervention group(n=35)and control group(n=35)according to whether they received treatment with the traditional Chinese medicine fistula-protecting patch.The blood flow and venous diameter of the two groups of patients were counted before treatment and after two months of treatment.After two months of treatment,the AVF maturation time,pump-controlled blood flow during dialysis,occurrence of AVF-related complications,mental state scores,and numerical rating scale(NRS)scores were compared between the two groups of patients.The first patency rate and average patency time of the two groups of patients were recorded.Result After two months of treatment,the blood flow and intravenous diameter of the two groups of patients were higher than those before treatment,both parameters of the intervention group were higher than those of the control group,the differences were statistically significant(P<0.05).After two months of treatment,the pump-controlled blood flow of patients in the intervention group during dialysis was higher than that of the patients in the control group,and the AVF maturation time was shorter than that of the patients in the control group,the differences were statistically significant(P<0.05).After two months of treatment,the NRS scores and mental state scores of the patients in the intervention group were lower than those before treatment and the control group,the differences were statistically significant(P<0.05);after two months of treatment,the NRS scores of the patients in the control group were lower than that before treatment and control group,the difference were statistically significant(P<0.05).The total incidence rate of AVF-related complications in the control group was 48.57%(17/35),higher than 42.86%(15/35)in the intervention group,but there was no statistically significant difference(P>0.05).The first patency rate of the patients in the intervention group was higher than that of the patients in the control group,and the first patency time was longer than that of the patients in the control group,the differences were statistically significant(P<0.05).Conclusion The employment of the traditional Chinese medicine fistula protective patch could effectively increase blood flow,venous diameter,and pump-controlled blood flow during dialysis,shorten the maturation time of internal fistula,effectively extend the use time of AVF,reduce the incidence of complications related to internal fistula,and its safe,which is worthy of clinical promotion and application.