前列地尔联合双嘧达莫对尿毒症患者内瘘术后的影响

摘要

目的：观察前列地尔联合双嘧达莫对尿毒症患者内瘘的影响。方法：将55例非透析尿毒症患者实施动静脉内瘘手术，术后分为对照组和治疗组。对照组给予双嘧达（25 mg，3次/日）治疗，治疗组在对照组基础上联合前列地尔（10μg ，1次/日）治疗2周。治疗过程中，观察2组患者凝血功能、纤维蛋白原及血液黏滞度；比较2组患者内瘘成熟时间、血流量及内瘘狭窄率。结果：2组患者凝血功能较治疗前均有所延长(P<0.05)，但组间比较无差异。治疗组血液黏滞度较对照组显著下降(P<0.05)。与对照组相比，治疗组内瘘成熟时间显著缩短，且首次透析时内瘘血流量显著增加(P<0.05)。治疗组内瘘狭窄率与对照组相比显著下降(P<0.05)。结论：前列地尔联合双嘧达莫可促进尿毒症患者内瘘成熟，减少内瘘狭窄发生。%Objective:To observe the effect of co-administration of alprostadil and dipyridamole on arteriovenous ifstula in non-dialysis uremic patients.Methods: 55 non-dialysis uremia patients were performed arteriovenous ifstula operation, and after operation, they were divided into the treatment group and control group. The patients in control group were received dipyridamole (25 mg, three times a day). The patients in treatment group were administered with alprostadil (10 μg, once a day for 2 weeks) and dipyridamole (25 mg, three times a day). During the course of treatment, coagulation, ifbrinogen and blood viscosity were measured in both groups. Clinical therapeutic effects were observed, including fistula maturation time, blood flow and the rate of arteriovenous fistula stenosis.Results:After the treatment, coagulation time in two groups was longer than those before the treatment. Blood viscosity in the treatment group were signiifcantly decreased compared with that in control group (P<0.05). There was no signiifcant difference in blood viscosity in the control group compared with that before treatment. The maturation time and blood lfow of arteriovenous ifstula in treatment group were better than those in control group (P<0.05). The rate of ifstula stenosis in treatment group was decreased signiifcantly compared with that in control group (P<0.05).Conclusion: Co-administration of alprostadil and dipyridamole can promote arteriovenous ifstula maturation and reduce the rate of arteriovenous ifstula stenosis in uremic patients.