人造动静脉内瘘血栓形成后围介入治疗期间护理

目的探讨人造血液透析瘘管血栓阻塞后经肱动脉顺行介入置管溶栓期间的护理措旋及临床价值。方法经同侧肱动脉顺行穿刺插管，先以导丝、导管松解、碎裂血栓，再留置导管持续溶栓，术中团注10万U尿激酶，随后微泵2万U／h维持溶栓，部分狭窄段行球囊成形术，分析围手术不同时期的护理实践及效果。结果19例经介入置管溶栓及球囊成形后18例开通，开通率达94．7％，血栓形成时间〈72h为17例，24h内溶栓再通17例（100％），尿激酶用量在30-80万U；血栓形成时间〉72h为2例，1例部分溶栓再通，以球囊扩张后开通，1例溶栓超过48h后出现局部血肿，放弃溶栓。结论经肱动脉介入顺行碎栓、溶栓在维持血液透析管通畅方面安全、有效、简便而且微创。围介入治疗期间恰当的护理非常重要。

Peri- interventional nursing of thrombosis after artificial arteriovenous fistula

Objective To investigate periinterventional nursing of thrombosis after artificial arteriovenous fistula. Methods The catheter was inserted along ipsilateral brachial artery. The wire and catheter were first released to fragmentate thrombus. Then the catheter was left to maintain thrombolvsis. Intraoperative bolus ir~jection of 100 000 U of urokinase was performed, followedthe thrombolysis was discontinued. Conclusion The method of fragmentating thrombus along hrachial artery proves to be safe, effective and simple, and minimally invasive. Appropriate nursing of peri - interventional period is of importance to a successful surgery.