贝前列腺素钠联合氯吡格雷对尿毒症患者动静脉内瘘手术成功率的影响

发布时间：2018-07-20 17:42

【摘要】：目的:探讨贝前列腺素钠联合氯吡格雷对尿毒症患者动静脉内瘘手术成功率的影响。方法:回顾性分析动静脉内瘘手术后建立长期血管通路的345例患者的临床资料,按治疗方法的不同随机分为观察组(180例)和对照组(165例)。对照组患者给予常规护理和治疗;观察组患者在对照组治疗的基础上给予贝前列素钠片40μg、口服、tid+氯吡格雷75 mg、首次剂量300 mg、晨服。两组患者疗程均为1个月。观察两组患者动静脉内瘘手术成功率,术后内瘘成熟首次使用时间、平均内瘘血流量,治疗前后凝血酶原时间、血压及不良反应发生情况。结果:观察组患者动静脉内瘘手术成功率显著高于对照组,两组比较差异有统计学意义(P0.05)。观察组患者术后内瘘成熟首次使用时间显著短于对照组,平均内瘘血流量显著高于对照组,两组比较差异均有统计学意义(P0.01)。两组患者治疗前后凝血酶原时间及血压比较,差异均无统计学意义(P0.05)。两组患者治疗期间均未见明显不良反应发生。结论:贝前列腺素钠联合氯吡格雷可提高尿毒症患者动静脉内瘘手术成功率,缩短术后内瘘成熟首次使用时间,增加内瘘血流量,且安全性较好。
[Abstract]:Objective: to investigate the effect of beprostaglandin sodium combined with clopidogrel on the success rate of arteriovenous fistula in uremic patients. Methods: the clinical data of 345 patients who established long-term vascular access after arteriovenous fistula operation were retrospectively analyzed and randomly divided into observation group (180 cases) and control group (165 cases). The patients in the control group were given routine nursing care and treatment, the patients in the observation group were given berprostatin sodium tablets 40 渭 g, oral tid clopidogrel 75 mg, initial dose 300 mg, morning administration on the basis of the treatment in the control group. The course of treatment was 1 month in both groups. The successful rate of arteriovenous fistula operation, the first time of maturation of internal fistula, the mean blood flow of internal fistula, the prothrombin time, blood pressure and adverse reactions were observed before and after treatment. Results: the success rate of arteriovenous fistula in the observation group was significantly higher than that in the control group, and the difference between the two groups was statistically significant (P0.05). The first time of maturation of internal fistula in the observation group was significantly shorter than that in the control group, and the mean blood flow of the fistula was significantly higher in the observation group than in the control group, and the difference between the two groups was statistically significant (P0.01). There was no significant difference in prothrombin time and blood pressure between the two groups before and after treatment (P0.05). No significant adverse reactions occurred during treatment in both groups. Conclusion: Beprostaglandin sodium combined with clopidogrel can improve the success rate of operation of arteriovenous fistula in uremic patients, shorten the first time of maturation of postoperative internal fistula, increase blood flow of internal fistula, and have good safety.
【作者单位】：绵阳市中心医院肾内科;
【分类号】：R692.5

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