不同浓度尿激酶联合肝素封管在静脉导管溶栓中的应用

目的:探讨不同浓度尿激酶联合肝素封管对中心静脉留置导管溶栓的疗效。方法:选择2013年9月~2014年3月我院收治的维持性血液透析留置中心静脉导管伴有导管血栓形成312例患者为研究对象,随机分为3组,试验组分为A、B两组,其中A组112例患者采用尿激酶浓度20 000μ/ml联合常规肝素25 mg/ml封管,B组104例采用尿激酶浓度5000μ/ml联合肝素25 mg/ml封管,对照组C组96例单独采用肝素25 mg/ml封管,观察3组患者血流量、导管再通率及溶栓前后PT,APTT指标。结果:3组导管再通率和血流量相比差异有统计意义(P0.05)。溶栓前后PT,APTT比较无统计学意义(P0.05)。结论:在护理操作严格规范下,采用5000~20 000μ/ml尿激酶浓度联合常规肝素25 mg/ml混合液封管,均能对中心静脉导管因血栓形成导致血流不畅有较好的溶栓作用,是处理中心静脉导管堵塞的有效方法。

Effect of different concentration urokinase and heparin on thrombosis in central venous catheter

Objective ：The effect of different concentration urokinase and heparin on venous catheter thrombosis. Methods：312 hemodialysis patients with central venous catheter which had the thrombosis as the experimental group,used 5000 and 20 000 μ/ml urokinase and 25 mg/ml heparin mixture sealing tube, which divided into A group （112 patients）and B group （104 patients）. And used 25 mg/ml heparin fluid sealing tube the as the control group, that was called C group （96 patients）. Results：The recanalization rate and blood flow among three groups had statistical significance （P 〈 0.05 ）. Before and af- ter the tube sealing, there was no significant difference on the PT, APTI＇ （P 〉 0.05 ）. Conclusion：The concentration from 5000 to 20 000 μ/ml urokinase with heparin, with strictly nursing procedures, both of them have a better effect of thrombolysis in the blocking of central venous catheter.