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目的比较尿激酶预防性溶栓与非预防性溶栓在血液透析中的临床效果。方法选取苏州市吴江区第一人民医院血透室2015年3月—2016年12月收治的慢性肾衰竭维持性血液透析患者56例,随机分为治疗组和对照组,各28例。治疗组患者采用尿激酶预防性溶栓,对照组患者则未采用预防性溶栓。比较两组患者导管再通情况及透析前后活化部分凝血活酶时间(APTT)、凝血酶原时间(PT),观察患者不良反应发生情况。结果治疗组患者导管再通率高于对照组(P<0.05)。透析前,两组患者APTT、PT比较,差异无统计学意义(P>0.05);透析后,治疗组患者APTT、PT长于对照组(P<0.05)。两组患者不良反应发生率比较,差异无统计学意义(P>0.05)。结论尿激酶预防性溶栓在血液透析患者中的应用效果较好,可维持血管通畅,改善凝血时间,且安全性好。
Objective To compare the clinical effects of prophylactic thrombolysis and non-prophylactic thrombolysis in hemodialysis. Methods Fifty-six patients with chronic renal failure and maintenance hemodialysis admitted to the Hemodialysis Hospital of First People’s Hospital of Wujiang District, Suzhou from March 2015 to December 2016 were randomly divided into treatment group (n = 28) and control group (n = 28). Patients in the treatment group received prophylactic thrombolysis with urokinase and patients in the control group did not receive prophylactic thrombolysis. The catheter recanalization and APTT and PT before and after dialysis were compared between the two groups to observe the adverse reactions of the patients. Results The recanalization rate of catheter in treatment group was higher than that in control group (P <0.05). Before dialysis, there was no significant difference in APTT and PT between the two groups (P> 0.05). After dialysis, APTT and PT in the treatment group were longer than those in the control group (P <0.05). Two groups of patients with adverse reactions, the difference was not statistically significant (P> 0.05). Conclusions Urokinase prophylactic thrombolysis is effective in hemodialysis patients, which can maintain the patency of blood vessels and improve the clotting time, with good safety.