Objective To study the effects of prostaglandins E1 on arteriovenous fistula in patients of hemodialysis. Methods One hundred and twenty uremia patients were randomly divided into two groups: treatment group and control group. The treatment group received prostaglandins E1 and dipyridamole, while the control group only received dipyridamole after operation. The clinical therapeutic effects in both groups were observed, including blood platelet count, coagulation index, blood output, fistula patency and the first using time after fistula maturation. Results The primary patency rate one month after the procedure was 98.3％ ( 59/60 ) in the treatment group vs. 86.7％ ( 52/60 ) in the control group ( P＜0.05 ). The blood output was (466±147)mL · min-1 in the treatment group vs. ( 351±89 )mL · min-1 in the control group ( P＜0.01 ). The first using time after fistula maturation was ( 22.7±4.3 ) d in the treatment group vs. ( 28.2±7. 1 )d in the control group ( P＜0.01 ). The differences of blood platelet count, coagulation index between the pre and post therapy in the treatment group did not reach statistical significance. Conclusion Prostaglandins E1 may have a beneficial effect in the creation of an arteriovenous fistula by increasing blood flow, improving initial patency and fistula maturation but doesn't increase the risk of bleeding.%目的 探讨维持性透析患者动静脉造瘘术后应用前列腺素E1对于动静脉内瘘功能的影响.方法 120例维持性透析患者,拟行动静脉造瘘术前按完全随机设计分为治疗组和对照组各60例.对照组动静脉造瘘术后常规给予抗血小板聚集治疗,口服双嘧达莫50 mg, tid,治疗组在此基础上给予前列腺素E1 10 μg,溶于0.9%氯化钠注射液10 mL后静脉缓慢推注,qd;术后1周检测患者血小板计数、凝血功能.术后1个月用彩色多普勒超声测定动静脉瘘血流量,了解通畅情况,并记录治疗组和对照组内瘘成熟后血管初次血液透析使用的时间.结果 治疗组1个月内瘘通畅59例(98.3%),对照组通畅52例(86.7%)(P＜0.05);治疗组内瘘血流量(466±147) mL·min-1,对照组为(351±89) mL·min-1(P＜ 0.01);治疗组内瘘初次使用时间(22.7±4.3)d,对照组为(28.2±7.1) d (P＜ 0.01).治疗组治疗前后血小板计数、凝血酶原时间、部分活化凝血活酶时间及凝血因子Ⅰ均无明显改变.结论 前列腺素E1能改善内瘘血流量,提高初期通畅率,促进内瘘的成熟,且不增大出血风险,具有较高的临床应用价值.
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