天津医药

天津医药 ›› 2019, Vol. 47 ›› Issue (12): 1244-1247.doi: 10.11958/20191864

• 临床研究 • 上一篇    下一篇

局部外用桂龙护瘘涂膜剂对血液透析患者炎症因子及自体动静脉内瘘成熟状态的影响

谭学惠1，卢晶晶1△，杨一楠1，韦芳宁2，谢娟1，熊成艳1，韦娟1，古小洪1   

  1. 1贵州中医药大学第二附属医院肾内科（邮编550000）；2广州中医药大学第二附属医院肾内科
  • 收稿日期:2019-06-21 修回日期:2019-08-02 出版日期:2019-12-15 发布日期:2020-03-10
  • 通讯作者: 卢晶晶 E-mail:298773900@qq.com
  • 作者简介:谭学惠（1973），女，副主任护师，本科，主要从事中医药干预血管通路并发症方面研究
  • 基金资助:
    局部外用桂龙护瘘涂膜剂对炎症因子及动静脉内瘘成熟的影响

Effects of Guilong fistula protective coating on inflammatory factors and maturation of autologousarteriovenous fistula in patients with hemodialysis

TAN Xue-hui1, LU Jing-jing1△, YANG Yi-nan1, WEI Fang-ning2, XIE Juan1, XIONG Cheng-yan1, WEI Juan1, GU Xiao-hong1   

  1. 1 Department of Nephrology, No.2 Affiliated Hospital of Guizhou University of TCM, Guiyang 550000, China; 2 Department of Nephrology, No.2 Affiliated Hospital of Guangzhou University of TCM
  • Received:2019-06-21 Revised:2019-08-02 Published:2019-12-15 Online:2020-03-10
  • Supported by:
     

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摘要： 目的 探讨局部外用桂龙护瘘涂膜剂对血液透析患者炎症因子及自体动静脉内瘘成熟状态的影响。方 法 选择贵州中医药大学第二附属医院肾内科血透室收治的92例慢性肾功能衰竭患者为研究对象，所有患者均行 自体动静脉瘘手术，用随机数字表法将患者分为2组，观察组（46例）术后采用桂龙护瘘涂膜剂沿内瘘血管外涂，对照 组（46例）给予常规内瘘护理。观察2组治疗前后自体动静脉瘘血管壁厚度、动脉阻力指数、血流量、血管条件、血清 炎性因子、内瘘失功率的差异。结果 观察组术后8周血管壁厚度、动脉阻力指数低于对照组（P＜0.01），血流量大 于对照组（P＜0.01），血管弹性良好、弱血管杂音比例高于对照组（P＜0.01）。观察组用药 8 周后血清白细胞介素 （IL）-6、肿瘤坏死因子（TNF）-α、降钙素原（PCT）、C反应蛋白（CRP）水平均低于对照组（P＜0.01），2组术后1年自体 动静脉瘘失功率差异无统计学意义（P＞0.05）。结论 局部外用桂龙护瘘涂膜剂可降低自体动静脉瘘血管厚度和阻 力，增加血流量，改善血管条件，降低术后炎性反应，促进内瘘成熟。

关键词: 肾透析, 动静脉瘘, 超声检查, 多普勒, 桂龙护瘘涂膜剂, 自体动静脉内瘘, 炎症因子

Abstract: Objective To investigate the effect of Guilong fistula protective coating on inflammatory factors and maturation of autologous arteriovenous fistula in patients with hemodialysis. Methods Ninety-two patients with chronic renal failure admitted to the dialysis department of Second Affiliated Hospital of Guizhou University of Traditional Chinese Medicine were selected as the research objects. All patients underwent autologousarterivenous fistula operation. The patients were divided into two groups by random number table. The observation group (n=46) was treated with Guilong fistula protective coating along the internal fistula vessels after operation, and the control group (n=46) was given routine internal fistula nursing. The differences of wall thickness, arterial resistance index, blood flow, blood vessel condition, serum inflammatory factors and fistula loss power were observed before and after treatment between the two groups. Results The vascular wall thickness and arterial resistance index were greater in the observation group than those of the control group at 8 weeks after operation (P＜0.01). The blood flow was greater in the observation group than that of the control group (P＜0.01), and the vascular elasticity was good, the proportion of weak vascular murmur was higher than those of the control group (P＜ 0.01). The serum levels of IL-6, tumor necrosis factor (TNF) -α, procalcitonin (PCT) and C-reactive protein (CRP) were significantly lower at 8 week in the observation group than those in the control group (P＜0.01). There was no significant difference in the power loss of autologousarteriovenous fistula at 1 year after operation between the two groups (P＞0.05). Conclusion Local external application of Guilong fistula protective coating can reduce the thickness and resistance of the arteriovenous fistula, increase blood flow, improve vascular condition, reduce the inflammatory reaction after operation, and promote the maturation of the internal fistula.

Key words: renal dialysis, arteriovenous fistula, ultrasonography, doppler, guilong fistula protective coating, autologousarteriovenous fistula, inflammatory factors

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