四步按摩法在维持性血液透析患者内瘘血栓形成后的应用

摘要

Objective To investigate the curative effect of four-step massage method in maintenance hemodialysis patients with thrombosis of arteriovenous fistula.Methods Thirty-six patients with acute thrombosis in forearm autogenous internal arteriovenous fistula were enrolled in this study and separated into the control group (18 cases)and the research group (18 cases).Routine massage method was implemented in control group,while four-step massage method was implemented in research group.Both of them were followed by continous intravenous pumping of urokinase.The success rate of thrombolytic therapy, blood flow volume during the first time dialysis after recanalization,duration treatment,and the occurrence rate of hematomas were compared between two groups.Results In research group,the recanalization rate and blood flow volume during the first time dialysis were significantly higher than those in control group, while the treatment duration and the occurrence rate of hematomas were significantly lower than those in control group(P <0.05).Conclusion For maintenance hemodialysis patients with acute thrombosis in forearm autogenous internal arteriovenous fistula,four-step massage method combined with urokinase showed higher success rate,faster recanalization and fewer hematomas rate in thrombolysis and it worths clinical promoting.%目的 观察运用四步按摩法治疗动静脉内瘘急性血栓形成的疗效.方法 纳入前臂自体动静脉内瘘急性血栓形成患者36例,按照治疗手法不同分为两组.对照组实行常规按摩手法,研究组采用四步按摩法,均配合尿激酶持续静脉泵入溶栓,对比两组溶栓治疗的成功率、透析血流量、治疗时间及血肿并发症等情况.结果 研究组再通率高于对照组,透析血流量大于对照组,而研究组治疗时间、血肿发生率低于对照组(P<0.05).结论 对自体动静脉内瘘急性血栓形成的血液透析患者,经四步手法按摩联合药物溶栓治疗成功率高,再通快,血肿发生率低,值得临床推广.