中国基层医药
中國基層醫藥
중국기층의약
Chinese Journal of Primary Medicine and Pharmacy
2015年
23期
3576-3578,3579
,共4页
血液透析滤过%导管插入术,中心静脉%华法林%阿司匹林
血液透析濾過%導管插入術,中心靜脈%華法林%阿司匹林
혈액투석려과%도관삽입술,중심정맥%화법림%아사필림
Hemodiafiltration%Catheterization,central venous%Warfarin%Aspirin
目的：探讨华法林与阿司匹林用于治疗血液透析患者长期中心静脉置管功能不良的效果及安全性。方法选择采取留置长期中心静脉导管行血液透析治疗肾功能衰竭患者共62例，按随机数字表法分为华法林组（31例），阿司匹林组（31例）。所有患者常规肝素封管；华法林组患者在此基础上给予华法林片，阿司匹林组患者给予阿司匹林肠溶片。记录两组患者经过40次血液透析治疗过程中发生导管功能不良的情况以及尿素清除指数增加值、凝血功能、是否发生出血事件以及导管相关感染的发生情况。结果华法林组3例发生导管功能不良，发生率为9．68％，阿司匹林组发生8例导管功能不良，发生率25．81％，华法林组导管功能不良发生率较阿司匹林组更低（χ2＝9．081，P ＜0．05）；华法林组尿素清除指数增加（0．13±0.07），阿司匹林组尿素清除指数增加（0．04±0．03），华法林组明显高于阿司匹林组（t ＝0．941，P ＜0．05），而两组治疗前后的凝血酶原时间及活化部分凝血活酶时间变化组间比较差异均无统计学意义（t ＝0．001、0.003、0．001，均P ＞0．05）。两组均无感染病例。治疗后华法林组发生肢体淤斑和结膜出血各1例，阿司匹林组发生1例结膜出血及1例牙龈出血。结论华法林治疗血液透析长期置管功能不良效果优于阿司匹林。
目的：探討華法林與阿司匹林用于治療血液透析患者長期中心靜脈置管功能不良的效果及安全性。方法選擇採取留置長期中心靜脈導管行血液透析治療腎功能衰竭患者共62例，按隨機數字錶法分為華法林組（31例），阿司匹林組（31例）。所有患者常規肝素封管；華法林組患者在此基礎上給予華法林片，阿司匹林組患者給予阿司匹林腸溶片。記錄兩組患者經過40次血液透析治療過程中髮生導管功能不良的情況以及尿素清除指數增加值、凝血功能、是否髮生齣血事件以及導管相關感染的髮生情況。結果華法林組3例髮生導管功能不良，髮生率為9．68％，阿司匹林組髮生8例導管功能不良，髮生率25．81％，華法林組導管功能不良髮生率較阿司匹林組更低（χ2＝9．081，P ＜0．05）；華法林組尿素清除指數增加（0．13±0.07），阿司匹林組尿素清除指數增加（0．04±0．03），華法林組明顯高于阿司匹林組（t ＝0．941，P ＜0．05），而兩組治療前後的凝血酶原時間及活化部分凝血活酶時間變化組間比較差異均無統計學意義（t ＝0．001、0.003、0．001，均P ＞0．05）。兩組均無感染病例。治療後華法林組髮生肢體淤斑和結膜齣血各1例，阿司匹林組髮生1例結膜齣血及1例牙齦齣血。結論華法林治療血液透析長期置管功能不良效果優于阿司匹林。
목적：탐토화법림여아사필림용우치료혈액투석환자장기중심정맥치관공능불량적효과급안전성。방법선택채취류치장기중심정맥도관행혈액투석치료신공능쇠갈환자공62례，안수궤수자표법분위화법림조（31례），아사필림조（31례）。소유환자상규간소봉관；화법림조환자재차기출상급여화법림편，아사필림조환자급여아사필림장용편。기록량조환자경과40차혈액투석치료과정중발생도관공능불량적정황이급뇨소청제지수증가치、응혈공능、시부발생출혈사건이급도관상관감염적발생정황。결과화법림조3례발생도관공능불량，발생솔위9．68％，아사필림조발생8례도관공능불량，발생솔25．81％，화법림조도관공능불량발생솔교아사필림조경저（χ2＝9．081，P ＜0．05）；화법림조뇨소청제지수증가（0．13±0.07），아사필림조뇨소청제지수증가（0．04±0．03），화법림조명현고우아사필림조（t ＝0．941，P ＜0．05），이량조치료전후적응혈매원시간급활화부분응혈활매시간변화조간비교차이균무통계학의의（t ＝0．001、0.003、0．001，균P ＞0．05）。량조균무감염병례。치료후화법림조발생지체어반화결막출혈각1례，아사필림조발생1례결막출혈급1례아간출혈。결론화법림치료혈액투석장기치관공능불량효과우우아사필림。
Objective To study the efficacy and safety of warfarin and aspirin in the treatment of adverse catheter function in long -term catheterization for hemodialysis.Methods 62 patients with renal failure treated with long -term central venous catheterization were selected,and all the patients were divided into the warfarin group (31 cases)and aspirin group(31 cases).Heparin in sealing was used in both two groups,and warfarin pill was given additionally in warfarin group,while aspirin pill was given additionally in aspirin group.The situation of adverse catheter function,coagulation,bleeding events,and catheter -related infections of the patients in the two groups were recorded during the time when they had 40 times of hemodialysis treatment.Results There were 3 cases of adverse catheter function in the warfarin group,the incidence rate was 9.68%,and there were 8 cases in the aspirin group,the incidence rate was 25.91%.The incidence rate in the warfarin group was lower than aspirin group(χ2 =9.081,P <0.05).The addition of urea remove index in the warfarin group was (0.13 ±0.07),which in the aspirin group was (0.04 ±0.03).The addition of urea remove index in the warfarin group was higher than aspirin group(t =0.941, P <0.05).There were no significant differences of PT,APTT and INR between the two groups(t =0.001,0.003, 0.001,all P >0.05).After treatment,there was 1 case of limb ecchymosis and 1 case of conjunctival hemorrhage in the warfarin group,and there was 1 case of conjunctival hemorrhage and 1 case of bleeding gums in the aspirin group. No catheter -related infections were found in the two groups.Conclusion Warfarin was better than aspirin in treating adverse catheter function in long -term catheterization for hemodialysis.
