CAJ | 학술논문

目的：探讨改良引血法对降低血液透析患者股静脉留置导管血栓形成的影响。方法选取2009年4月-2013年1月唐山市工人医院血液透析室经股静脉留置导管进行血液透析的患者292例，采用随机数字表法分为2组，应用常规引血法患者110例，应用改良引血法患者182例。于血液透析时分别采用常规引血法和改良引血法，并于血液透析1、2、3周时行导管内、导管周围及下肢深静脉彩色多普勒超声检查，对比两组血栓形成的发生率。结果血液透析1周时，改良引血法组血栓形成的发生率（1例，0.55%）略低于常规引血法组（3例，2.73%），差异无统计学意义（χ2=1.065，P =0.302）。血液透析2周时，改良引血法组血栓形成的发生率（4例，2.20%）低于常规引血法组（11例，10.00%），差异有统计学意义（χ2=8.565，P =0.003）。血液透析3周时，改良引血法组血栓形成的发生率（9例，4.95%）低于常规引血法组（21例，19.09%），差异有统计学意义（χ2=14.883，P =0.000）。结论改良引血法能有效降低3周内血液透析患者股静脉留置导管血栓形成的发生。
목적：탐토개량인혈법대강저혈액투석환자고정맥류치도관혈전형성적영향。방법선취2009년4월-2013년1월당산시공인의원혈액투석실경고정맥류치도관진행혈액투석적환자292례，채용수궤수자표법분위2조，응용상규인혈법환자110례，응용개량인혈법환자182례。우혈액투석시분별채용상규인혈법화개량인혈법，병우혈액투석1、2、3주시행도관내、도관주위급하지심정맥채색다보륵초성검사，대비량조혈전형성적발생솔。결과혈액투석1주시，개량인혈법조혈전형성적발생솔（1례，0.55%）략저우상규인혈법조（3례，2.73%），차이무통계학의의（χ2=1.065，P =0.302）。혈액투석2주시，개량인혈법조혈전형성적발생솔（4례，2.20%）저우상규인혈법조（11례，10.00%），차이유통계학의의（χ2=8.565，P =0.003）。혈액투석3주시，개량인혈법조혈전형성적발생솔（9례，4.95%）저우상규인혈법조（21례，19.09%），차이유통계학의의（χ2=14.883，P =0.000）。결론개량인혈법능유효강저3주내혈액투석환자고정맥류치도관혈전형성적발생。
Objective To explore the effects of modified blood drainage method on reducing incidence of thrombosis in femoral venous catheter among hemodialysis patients. Methods A total of 292 patients who received hemodialysis through femo-ral venous catheter at division of hemodialysis in Tangshan Worker′s Hospital from April 2009 to January 2013,were randomly di-vided into 2 groups. 110 patients were treated with conventional blood drainage method,and 182 patients were treated with modi-fied blood drainage method. The two groups received hemodialysis using conventional blood drainage method and modified blood drainage method,respectively,one week,two weeks and three weeks after the onset of dialysis,color Doppler ultrasound was used to check thrombosis within or around catheter,or in lower limb deep vein. The incidence of thrombus was compared be-tween the two groups. Results 1 week after the onset of dialysis,incidence of thrombus in modified blood drainage method group(1 case,0. 55% )was lower than that(3 cases,2. 73% )in conventional blood drainage method group,the difference was not significant( χ2 = 1. 065,P = 0. 302). 2 weeks after the onset of dialysis,incidence of thrombus in modified blood drainage method group(4 cases,2. 20% )was significantly lower than that(11 cases,10. 00% )in conventional blood drainage method group,the difference was significant( χ2 = 8. 565,P = 0. 003). 3 weeks after the onset of dialysis,incidence of thrombus in modified blood drainage method group(9 cases,4. 95% )was significantly lower than that(21 cases,19. 09% )in conventional blood drainage method group,the difference was significant(χ2 = 14. 883,P = 0. 000). Conclusion Modified blood drainage method can effectively reduce incidence of thrombosis in femoral venous catheter among patients who receive hemo-dialysis within 3 weeks.