中药外敷联合TDP对慢性肾衰竭患者动静脉内瘘功能不良的影响

目的:观察中药外敷联合TDP照射对慢性肾衰竭患者动静脉内瘘功能不良的影响。方法:选取铜陵市中医医院及铜陵市第五人民医院2018年1月—2019年9月期间接受维持性血液透析治疗的60例慢性肾衰竭患者作为试验研究对象,随机分为治疗组和对照组,每组30例。对照组采用喜辽妥软膏外涂,治疗组应用中药外敷联合TDP照射治疗,疗程二月。观察两组患者治疗前后内瘘功能不良的发生及改善情况,同时行彩色多普勒超声检查,分别测定治疗前后患者内瘘口直径、血管壁厚、内瘘血流量。结果:治疗后两组临床疗效比较,治疗组总有效率高达96.67%,远高于对照组76.67%,差异有统计学意义(P<0.05)。两组治疗后内瘘口直径、血管壁厚、内瘘血流量、透析中血流量指标数值均较治疗前明显升高(P<0.05),治疗组治疗后各项指标较对照组升高更为显著(P<0.05)。结论:TDP照射联合中药外敷能减少内瘘狭窄、栓塞、皮下血肿等血管通路并发症的发生,提高透析治疗血流量,延长动静脉内瘘使用寿命。

Effect of External Application of Chinese Medicine Combined with TDP on Dysfunction of Arteriovenous Fistula in Patients with Chronic Renal Failure

Objective:To observe the effect of external application of Chinese medicine combined with TDP irradiation on dysfunction of arteriovenous fistula.Methods:Select 60 patients with chronic renal failure who received maintenance hemodialysis from Tongling City Hospital of Traditional Chinese Medicine and Tongling Fifth People’s Hospital from January 2018 to September 2019,and randomly divide them into treatment group and control group,30 cases per group.The control group was applied with Xiluotu ointment,and the treatment group was treated with external application of Chinese medicine combined with TDP irradiation,and the course of treatment was two months.Observe the occurrence and improvement of internal fistula dysfunction before and after treatment in both groups.Color Doppler ultrasonography was performed at the same time to measure the internal fistula diameter,blood vessel wall thickness,and internal fistula blood flow before and after treatment.Results:After the treatment,the clinical efficacy of the two groups was compared.The total effective rate of the treatment group was as high as 96.67%,much higher than that of the control group of 76.67%.The difference was statistically significant(P<0.05).After treatment,the values of internal fistula diameter,blood vessel wall thickness,internal fistula blood flow,and blood flow during dialysis were significantly higher than before treatment(P<0.05).After treatment,each index of the treatment group was higher than that of the control group.Is significant(P<0.05).Conclusion:TDP irradiation combined with external application of traditional Chinese medicine can reduce the occurrence of complications of vascular access such as internal fistula stenosis,embolism,and subcutaneous hematoma,increase the blood flow of dialysis treatment,and prolong the service life of arteriovenous fistula.