中国血液净化

›› 2011, Vol. 10 ›› Issue (4): 198-200.doi: 10.3969/j.issn.1671-4091.2011.04.00

• 临床研究 • 上一篇    下一篇

尿激酶溶栓治疗人工血管动静脉内瘘急性血栓形成

郭相江 赵意平 施娅雪 叶 猛 孙敏莉 张 皓 张纪蔚   

  1. 上海交通大学医学院附属仁济医院血管外科
  • 收稿日期:2010-09-30 修回日期:1900-01-01 出版日期:2011-04-12 发布日期:2011-04-12
  • 通讯作者: 施娅雪

The effects of urokinase in the treatment of acute thrombosis in arterio-venous graft

GUO Xiang-jiang, ZHAO Yi-ping, SHI Ya-xue, YE Meng, SUN Min-li, ZHANG Hao, ZHANG Ji-wei.   

  1. Department of Vascular Surgery, Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200001, China
  • Received:2010-09-30 Revised:1900-01-01 Online:2011-04-12 Published:2011-04-12

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摘要： 目的 总结尿激酶溶栓治疗人工血管动静脉内瘘急性血栓形成的方法及经验。 方法 采用人工血管动脉端输液针局部穿刺，尿激酶微量泵持续灌注溶栓作为首选措施治疗人工血管动静脉内瘘急性血栓形成。 结果 共观察人工血管动静脉内瘘急性血栓形成20例，男性6例，女性14例，平均年龄(61.42±13.30)岁。人工血管动静脉内瘘建立时间1月～8年。急性血栓形成病程1 h～6 d。溶栓成功14例，溶栓失败6例，成功率70%。平均溶栓时间为(10.73±5.94)h，平均尿激酶溶栓剂量为(81.75±40.01)万U。溶栓成功率与静脉流出道状态显著相关。 结论 尿激酶直接注射溶栓治疗简便、安全、有效，使进一步球囊扩张成为可能，并减少临时血液透析插管及手术重建及其相关并发症，可作为人工血管内瘘血栓形成的首选方法。

关键词: 人工血管动静脉内瘘, 溶栓, 尿激酶

Abstract: 【Abstract】 Objectives To summarize the experience to treat acute thrombosis in arterio-venous graft by thrombolysis using urokinase. Methods Thrombolysis was used as the first step to treat thrombosis in arterio-venous graft by puncture into the graft near the arterial end and continuous infusion of urokinase. Results We observed 20 cases with acute thrombosis in arterio-venous graft, of whom the mean age was 61.42±13.30 yrs, 6 cases were males and 14 cases were females. The arterio-venous grafts were established for 1 month to 8 years, and the thrombosis was detected within 6 days. Thrombolysis was successful in 14 cases (70%), with the mean thrombolysis duration of 10.73±5.94 hrs and mean urokinase dose of 817,500±400,100 units. The successful rate was closely related to the status of the venous outflow. Conclusions Thrombolysis by local continuous infusion of urokinase is a simple, safe and effective method. It facilitates other intervention techniques, and avoids the complications from catheterization or graft reconstruction for vascular access. Therefore, this method may become the first choice for the management of thrombosis in arterio-venous graft.

Key words: Thrombolysis, Urokinase

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