自制复方丹参喜疗妥软膏预防血液透析患者动静脉内瘘并发症的效果观察

目的探讨自制复方丹参喜疗妥软膏预防血液透析患者动静脉内瘘并发症的效果。方法将2005年6月—2007年1月在血液净化中心使用新内瘘的维持性血液透析患者60例,采用随机数字表法随机分为对照组和观察组各30例。对照组按动静脉内瘘穿刺后常规处理,即透析结束采用弹力绷带配合指压压迫止血5 min,30 min后解除弹力绷带,指导患者在血液透析治疗结束24 h后行湿热敷和握力器锻炼,每日2～3次;观察组在对照组的基础上于透析治疗结束24 h后用自制的复方丹参喜疗妥软膏涂抹动静脉内瘘及周围皮肤组织并按摩,每日1次。观察两组内瘘在12个月内发生栓塞、狭窄、动脉瘤、局部血管硬化等并发症情况。结果观察组与对照组动静脉内瘘血管硬化、狭窄、动脉瘤、栓塞等并发症发生情况进行比较,差异均有统计学意义（P〈0.05）。结论复方丹参喜疗妥软膏能降低动静脉内瘘并发症的发生率,有效延长维持性血液透析患者内瘘的使用时间。

Self-prescribed Compound Danshen Hirudoid Ointment in the Prevention of Complications Included by Internal Arteriovenous Fistula in MHD Patients

Objective To study the effect of self-prescribed compound Danshen hirudoid ointment in the prevention of complications included by internal arteriovenous fistula in patients undergoing maintenance hemodialysis （MHD）. Methods 60 patients admitted from June 2005 to January 2007 for MHD using internal arteriovenous fistula were equally assigned into control and observation groups by random digits table. In the control group, internal arteriovenous fistula was punctured and treated routinely. After hemodialysis, haemostasis was performed by finger pressure and elastic bandage for 5 minutes. With the bandage removed 30 minutes later, the patients were instructed to take wet-hot compress and exercises on hand-muscle developer two or three time every day, 24 hours after finish of hemodialysis. Besides routine treatment in the control, self-prescribed compound Danshen hirudoid ointment, in the observation group, was applied on the internal arteriovenous fistula and the skin around fistula for massage once every day, 24 hours after hemodialysis. The two groups were compared in view of such complications as embolism, stricture, aneurysm and vascular sclerosis. Results In such complications as embolism, stricture, aneurysm and vascular sclerosis, there were significant differences between the two groups （P〈0.05）. Conclusion Compound Danshen hirudoid ointment can reduce the complication rate in internal arteriovenous fistula and effectively lengthen the duration of internal arteriovenous fistula for MHD.