摘要
目的探讨抗血小板药在治疗长期留置血液透析导管晚期功能不良中的效果及不良反应。方法收集我科在2004年8月至2008年12月间出现深静脉长期留置血液透析导管晚期功能不良且需反复行尿激酶导管内溶栓治疗的维持血透患者共16例。16例患者均在尿激酶导管内溶栓开始1个月后在溶栓的同时加用抗血小板药:阿司匹林肠溶片0.1 g每日1次和盐酸噻氯匹定0.25 g每日1次。统计加用抗血小板药前后1个月内尿激酶导管内溶栓次数及尿激酶总用量;并在用药1个月后复查血常规、凝血功能与用药前做对比;同时收集用药后不良反应出现情况。结果16例患者在加用抗血小板药前尿激酶导管内溶栓治疗次数为(2.56±0.72)次/月,尿激酶总用量(114.35±33.28)万U/月;加用抗血小板药后尿激酶导管内溶栓治疗次数为(0.63±0.46)次/月(P<0.01),尿激酶总用量(13.74±6.82)万U/月(P<0.01)。用药前后血红蛋白、血小板、凝血时间、部分凝血活酶时间、纤维蛋白原无显著性差异。加用抗血小板药后有1例患者反复出现皮下瘀斑。结论抗血小板药可以减少长期留置血液透析导管晚期功能不良治疗时的尿激酶导管内溶栓次数及尿激酶用量,有效防治长期留置导管晚期功能不良。
Objective To discuss the efficacy and side - effects of antiplatelet drugs in the treatment of patients with late dysfunction of long - term indwelling catheters. Methods Clinical data was collected from 16 maintenance hemodialysis patients with late dysfunction of deep venous long - term indwelling catheters from August 2004 to December 2008. The patients were treated in our department and repeated urokinase intracatheter thrombolysis therapy was required for them. All 16 patients were given antiplatelet drugs（ Bay aspirin 0. 1 g qd and Ticlid 0.25 g qd） and thrombolytic agents after I month of urokinase intracatheter thrombolysis therapy. The frequency of urokinase intracatheter thrombolysis therapy and the total dosage of nmkinase administed per month were calculated before and after the usage of antiplatelet drugs. One month after the administration of antiplatelet drugs, the count of blood cells（ CBC）, coagulation function were monitored to compare with those before antiplatelet treatment. Meanwhile, the adverse reactions of medicine were observed. Results Before antiplatelet treatment, the frequency of urekinase intracatheter thrombolysis therapy in 16 patients was 2.56 ± 0.72 times/month, the total dosage of urokinase administed was 114.35 ± 33.28 kU/month ; after antiplatelet treatment, the frequency of urokinase intraeatheter thrombolysis therapy was 0.63 ± 0.46 times/month （ P 〈 0.01 ）, the total dosage of urokinase was 13.74 ±6.82 kU/month （ P 〈 0.01 ）. The hemoglobin （ Hb ）, platelet （ PLT）, prethrombin time （ PT）, activated partial thromboplastin time（APTT） and fibrinogen showed no significant difference before and after antiplatelet treatment. Only one case came up with subcutaneous ecchymosis after the usage of antiplatelet drugs. Conclusion In hemodialysis patients with late dysfunction of long - term indwelling catheters, the use of antiplatelet drugs can reduce the frequency of urokinase intracatheter thrombolysis therapy and the total dosage of urokinase, and prevent long -term indwelling catheters from late dysfunction effectively.
出处
《临床和实验医学杂志》
2009年第9期20-22,共3页
Journal of Clinical and Experimental Medicine
