中国血液净化

›› 2002, Vol. 1 ›› Issue (10): 12-14.

• 论著 • 上一篇    下一篇

大剂量尿激酶溶栓治疗内瘘血栓形成

伦立德 孙红 李伟生 朱晓明 屈国林 陈肇一   

  1. 100036 北京，空军总医院肾病科
  • 收稿日期:1900-01-01 修回日期:1900-01-01 出版日期:2002-10-19 发布日期:2002-10-19

  • Received:1900-01-01 Revised:1900-01-01 Online:2002-10-19 Published:2002-10-19

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摘要： 【摘要】目的 探讨外周和经皮穿刺股动脉导管注入尿激酶对动静脉内瘘血栓形成的治疗效果。方法 对16例内瘘血栓形成的患者分别进行了外周溶栓和股动脉插管溶栓治疗。方法是12例患者于内瘘的动脉端穿刺后输注尿激酶，4例患者在DSA下经动脉插管至血栓部位，灌注尿激酶，尿激酶用量为75～100万IU，外周溶栓输注时间为3～4小时，导管溶栓时间为45～60分钟。结果 12例外周溶栓患者再通6例，外周溶栓成功率为50%，6例失败，其中4例进行了插管溶栓，3例成功，1例失败，成功率为75%，再通后的内瘘次日可行血液透析，并随访了6～44个月，情况良好。结论 尿激酶局部输注治疗内瘘血栓形成是安全有效的，可以作为首选的治疗措施。

关键词: 动静脉内瘘, 尿激酶, 动脉插管, 透析患者, 数字减影

Abstract: 【Abstract】Objective To study the effect of urokinase on thrombosis of the arteriovenous fistulas by peripheral artery infusion and intraarterial infusion. Methods 12 patients with thrombosis of the angioaccess were infused urokinase via a small needle into the feeding artery, 4 patients were performed intra-arterial urokinase infusion into artery extrimity of the thrombus at DSA unit. The dosage of urokinase was 750,000～1,000,000IU, and the infusion time was average 3～4 hours. Result A complete thrombolysis with return of bruit and thrill was obtained in 50% patients by peripheral artery infusion and 75% patients by intra-arterial infusion. In follow-up 6～44 months,there are good patency in all the successful case after thrombolysis except of one case reclotted. conclusion Urokinase local infusion provides a useful means of preservation on arteriovenous fistula and may be used as the therapy of first choice in dialysis patients.

Key words: Urokinase, Intra-arterial infusion, Haemodialysis patients, Digital subtraction anglography