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《慢性病学杂志》[ISSN:1674-8166/CN:11-5900/R]

卷:

期数:

2014年02期

页码:

91-93

栏目:

论著

出版日期:

2014-03-20

文章信息/Info

Title:

Analysis of thrombolysis by use of urokinase for the treatment in27patients with arteriovenous internal leakage embolism

作者:

朱苓瑕; 罗福漳; 黄胜; 黄桂芳

南方医科大学附属南海医院肾内科，广东佛山528200

Author(s):

ZHULing -xia; LUOFu-zhang; HUANGSheng; HUANGGui-fang

DivisionofNephrology,NanhaiHospitalAffiliatedtoSouthMedicalUniversity,Foshan，Guangdong528200,China Corresponding author：LuoFu-zhang，E-mail:Luo1844@126.com

关键词:

尿激酶; 动静脉内瘘; 溶栓

Keywords:

Urokinase; Arteriovenous fistula; Thrombolysis

分类号:

R692.5

DOI:

-

摘要:

目的 探讨尿激酶溶栓治疗动静脉内瘘栓塞的时机、溶栓方案及影响其预后再通的因素。方法 回顾 性分析27例44例次尿激酶治疗动静脉内瘘栓塞患者的临床资料。采用SPSS13.0统计软件进行数据分 析，构成比及率的比较采用χ 2检验；多因素统计采用二分类logistic回归模型分析，P<0.05为差异有统计学 意义。结果 尿激酶治疗内瘘栓塞溶通率63.64%。血栓形成<6 h、6~24 h、>24 h溶通率分别为 72.41%、66.67%、16.67%，差 异 有 统 计 学 意 义（P<0.05）。尿 激 酶 走 速1万U/h中 溶 通10例 次 （47.62%），出血1例次（4.76%）；走速2万U/h中溶通14例次（87.50%），出血2例次（12.50%）；走速4 万U/h中溶通4例次（57.14%），出血3例次（42.86%），不同尿激酶走速组间溶通率差异有统计学意义 （P<0.05）。结论 血栓形成6 h内溶栓效果较好，24 h内溶栓仍获得较满意疗效；溶栓用尿激酶走速2万 U/h较佳。

Abstract:

ObjectiveTo study the reasons of causing arteriovenous internal leakage embolism in hemodi-alysis patients, timing, therapeutic course and related factors of urokinase application for the treatment of thrombosis in arteriovenous fistula. MethodsLocal injection of urokinase was used in27 cases in a total of 44 times for the treatment of thrombosis in fistula. The clinical data, curative effect and factors were measured before and after the treatment.ResultsThe thrombolytic treatment was used for the27 cases in a total of 44 times, of which 28 times (63.64%) showed successful results，and 6 times (13.64%) hemorrhaged. Successful results were found in72.41% cases,66.67% cases and16.67% caseswhose thrombosis respectively occurred less than6 hours, within 6-24 hours and more than 24 hours, there were significantly difference between them (P<0.05). Among them, 10 times (47.62%) showed successful results and 1 time (4.76%) hemorrhaged when the speed of urokinase was10 000 U/h;14 times (87.50%) showed successful results and2 times (12.50%) hemorrhaged when the speed of uroki-nase was 20 000 U/h;4 times (57.14%) showed successful results and3 times (42.86%) hemorrhaged when the speed of urokinase was40 000 U/h, there were significantly difference between them too (P< 0.05). ConclusionsThrombolysis shows better effect when thrombosis occurred within6 hours, but it also obtains curative effect for thrombolysis within 24 hours. It shows best effect when the speed of urokinase is 20 000 U/h for high rate of recurring thrombosis, low rate of hemorrhage and short time of thrombolysis.

参考文献/References:

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备注/Memo

备注/Memo:

作者简介：朱苓瑕，硕士，住院医师，主要从事肾内科临床诊疗工作 通信作者：罗福漳，E-mail:luo1844@126.com.cn

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更新日期/Last Update: 2014-07-07