常态尿激酶肝素封管在维护血透导管功能、预防感染中的应用评价

目的 研究长期规律应用尿激酶（urokinase,UK）加肝素封管对临时血透导管功能、相关性感染（CRI）的影响,阐明长期规律应用尿激酶（UK）加肝素封管临床应用意义.方法 选取使用右颈内静脉临时导管作为血管通路维持血透（MHD）的患者100例分成2组（实验组和对照组,每组50例）,给予2组不同的封管方案,比较2组导管功能障碍、血栓、导管相关性菌血症、凝血指标情况.结果 实验组可以降低导管功能障碍、腔内及尖端血栓、导管相关菌血症发生率（P＜0.05）,实验组和对照组附壁血栓发生率差异无统计学意义（P=0.420）,实验方案对凝血指标（血小板、凝血酶原时间、凝血酶时间、活化部分凝血活酶时间、纤维蛋白原凝血酶原、国际标准化比值）无影响（P＞0.05）.结论 长期规律应用尿激酶加肝素封管对维持临时性血透导管功能、减少管内血栓发生率、预防导管相关性菌血症安全有效.

Application and Evaluation of Normal Urokinase Heparin Tube Sealing in Maintenaning Hemodialysis Catheter Function and Prevention of Infection

Objective To research the influence of regular application of urokinase （UK）,heparin seal tube on temporary hemodialysis catheter function,related infections,so as to find out the clinical application significance of regular application of urokinase （UK） and heparin seal tube.Methods We selected 100 patients using right internal jugular vein catheter as temporary maintain hemodialysis （MHD） vascular access,and randomly divided them into two groups （experimental group and control group,each group of 50 patients）.The catheter dysfunction,blood clots,catheter-related bacteremia,coagulation indexes were compared between the two groups.Results The incidence rates of catheter dysfunction,cavity and tip thrombosis,catheter-related bacteremia were significantly lower in experimental group than those in control group （P＜0.05）,the incidence rates of mural thrombus had no significant difference between experimental group and control group （P=0.420）,the experimental scheme had no influence on coagulation indexes （Platelet,prothrombin time,prothrombin time,activated partial thromboplastin time,fibrinogen,prothrombin,international normalized ratio） （P＞ 0.05） Conclusions Regular application of urokinase （UK） and heparin seal tube is safe and effective in maintaining temporary hemodialysis catheter function,reducing tube thrombosis and prevention of catheter-related bacteremia.