本文選題：肝素涂層導管 + 血液透析��； 參考：《中國老年學雜志》2016年23期

【摘要】：目的觀察并比較老年透析患者應用Permcath導管與肝素涂層Palindrome導管后透析充分性,導管凝血功能變化,分析Palindrome導管臨床效果與安全性。方法選取45例老年慢性腎衰竭尿毒癥患者為研究對象。根據(jù)中心靜脈置管材料不同分為觀察組和對照組,觀察組(19例)均采用Palindrome導管置管,對照組(26例)采用常規(guī)Permcath導管,所有患者術(shù)后均保持隨訪12個月,記錄兩組患者置管前與1 w后凝血功能的變化,置管1 w與12個月后透析期間血流速度、尿素清除指數(shù)(Kt/V)以及隨訪期間血栓相關(guān)性導管功能不良、感染等并發(fā)癥的發(fā)生率。結(jié)果兩組患者均保持隨訪。隨訪期間觀察組感染率為10.5%(2/19),與對照組無明顯〔11.5%(3/26),P0.05〕差異。對照組6例出現(xiàn)導管不暢,觀察組2例出現(xiàn)導管不暢病例。對照組導管不暢率顯著高于觀察組(P0.05)。兩組患者置管1 w內(nèi)未出現(xiàn)明顯的凝血功能異常,觀察組與對照組的凝血酶原時間(PT)、部分活化凝血活酶時間(APT)、國際標準化比值(INR)均無明顯差異(P0.05)。觀察組12個月后的平均透析血流量、Kt/V較置管1 w時稍有降低,但差異不明顯(P0.05);對照組12個月后的平均透析血流量、Kt/V較置管1 w時明顯降低(P0.05)。置管后,觀察組平均透析血流量、Kt/V明顯高于對照組(P0.05)。結(jié)論老年透析患者置入肝素涂層Palindrome導管在控制導管相關(guān)性并發(fā)癥、維持透析充分性方面有顯著優(yōu)勢。
[Abstract]:Objective to observe and compare the dialysis adequacy and coagulation function of elderly dialysis patients with Permcath catheter and heparin coated catheter, and to analyze the clinical effect and safety of the catheter. Methods 45 elderly patients with chronic renal failure (CRF) were studied. According to the materials of central venous catheterization, all patients were divided into observation group and control group (19 cases of observation group) were treated with Palin syndrome catheter, and 26 cases of control group were treated with routine Permcath catheter. All the patients were followed up for 12 months after operation. The changes of coagulation function before and 1 week after catheterization, blood flow velocity, urea clearance index (KT / V) during dialysis at 1 week and 12 months after catheterization, and complications such as thrombus associated ductal dysfunction and infection during follow-up were recorded in both groups. Results the patients in both groups were followed up. During the follow-up period, the infection rate in the observation group was 10.5 / 19, and there was no significant difference between the observation group and the control group. In the control group, 6 cases had ductal obstruction, and 2 cases in the observation group. The incidence of ductal obstruction in the control group was significantly higher than that in the observation group (P 0.05). There was no obvious abnormal coagulation function in the two groups within 1 week after catheterization. There was no significant difference in prothrombin time (PTT), partial activated thromboplastin time (APT) and international standardized ratio (INR) between the observation group and the control group (P 0.05). The mean hemodialysis blood flow (KT / V) of the observation group after 12 months was slightly lower than that of the first week after catheterization, but the difference was not significant (P 0.05), and the average dialysis blood flow (Kt / V) of the control group after 12 months was significantly lower than that of the control group at 1 week after catheterization. After catheterization, the mean hemodialysis blood flow (KT / V) in the observation group was significantly higher than that in the control group (P 0.05). Conclusion Heparin coated Palin syndrome catheter has a significant advantage in controlling catheter-related complications and maintaining dialysis adequacy in elderly dialysis patients.
【作者單位】： 武漢市武昌醫(yī)院內(nèi)五科;
【基金】：武漢市衛(wèi)生局科研項目(WX15C19)
【分類號】：R459.5

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本文編號：1998695