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目的探讨尿激酶溶栓治疗动静脉内瘘栓塞的时机、溶栓方案及影响其预后再通的因素。方法回顾性分析27例44例次尿激酶治疗动静脉内瘘栓塞患者的临床资料。采用SPSS 13.0统计软件进行数据分析,构成比及率的比较采用χ2检验;多因素统计采用二分类logistic回归模型分析,P<0.05为差异有统计学意义。结果尿激酶治疗内瘘栓塞溶通率63.64%。血栓形成<6 h、6~24 h、>24 h溶通率分别为72.41%、66.67%、16.67%,差异有统计学意义(P<0.05)。尿激酶走速1万U/h中溶通10例次(47.62%),出血1例次(4.76%);走速2万U/h中溶通14例次(87.50%),出血2例次(12.50%);走速4万U/h中溶通4例次(57.14%),出血3例次(42.86%),不同尿激酶走速组间溶通率差异有统计学意义(P<0.05)。结论血栓形成6 h内溶栓效果较好,24 h内溶栓仍获得较满意疗效;溶栓用尿激酶走速2万U/h较佳。
Objective To investigate the timing of thrombolytic therapy of urokinase for thrombolysis of arteriovenous fistula, the thrombolytic therapy and the factors influencing its prognosis. Methods A retrospective analysis of 27 cases of 44 cases of urokinase in the treatment of arteriovenous fistula in patients with clinical data. SPSS 13.0 statistical software was used to analyze the data. The comparisons of composing rates and rates were performed using χ2 test. Multivariate statistics were analyzed by binary logistic regression model. P <0.05 was considered statistically significant. Results Urokinase treatment fistula embolization rate of 63.64%. Thrombosis <6 h, 6 ~ 24 h,> 24 h soluble rate was 72.41%, 66.67%, 16.67%, the difference was statistically significant (P <0.05). Urokinase walking speed 10000 U / h dissolved in 10 cases (47.62%), bleeding in 1 case (4.76%); walking speed of 20,000 U / h dissolved in 14 cases (87.50%), bleeding in 2 cases (12.50%); walking speed of 40 000 U / h in the dissolution of 4 cases (57.14%), bleeding in 3 cases (42.86%), the rate of different urokinase dissolution rate difference between groups were statistically significant <0.05). Conclusions Thrombolytic effect is better within 6 hours after thrombosis, and thrombolytic therapy within 24h is still satisfactory. Thrombolytic therapy with urokinase at a speed of 20,000 U / h is preferable.