中药熏洗联合木瓜酒湿敷对促进动静脉内瘘成熟的应用

[摘要] 目的 探讨中药熏洗联合木瓜酒湿敷用于促进自体动静脉内瘘成熟的有效性、安全性。 方法 将84例行动静脉内瘘成形术患者随机分为实验组和对照组，每组各42例，对照组给予常规治疗及护理，实验组在此基础上进行中药熏洗联合木瓜酒湿敷，观察用药前后患者血管头静脉内径、血流量变化，统计术后30d内内瘘闭塞、首次穿刺成功人数，比较两组内瘘成熟所有时间以及治疗情况。 结果 实验组血管狭窄改善、血流量改善、血管杂音增强、硬结软化治疗效果优于对照组，差异具有统计学意义（P<0.05）；术后30d实验组血流量、内径明显大于对照组，同时实验组内瘘形成用时较对照组短，差异具有统计学意义（P<0.05）。 结论 中药熏洗配合木瓜酒湿敷能有效促进内瘘成熟、提高内瘘质量，减少内瘘闭塞情况的发生。

[关键词] 木瓜酒；动静脉内瘘；中药熏洗；内瘘成熟

[中图分类号] R244.9 [文献标识码] A [文章编号] 2095-0616（2017）13-40-04

[Abstract] Objective To observe the efficacy and safety of papaya wine wet dressing and traditional Chinese medicine herbal fumigation in promoting maturation of autologous arteriovenous fistula. Methods 84 cases of arteriovenous fistula plasty were randomly divided into the experimental group and the control group with 42 cases in each group.Patients in control group were treated with routine treatment and nursing，and patients in experimental group were treated with fumigating with Chinese herbal medicine and wet compress of papaya wine on this basis.The change of vessel head vein diameter and blood flow volume of patients before and after meditation were compared.The incidence of patients internal fistula maturity after 30 days of operation and the success rate of first puncture were recorded.All the time and treatment of internal fistula mature were compared between two groups. Results The vascular stenosis improvement， blood flow volume improvement，the enhancement of vascular murmur and the softening of induration in the experimental group were better than those in the control group with P<0.05.After 30 days of operation， it could be found that the blood flow，diameter of experimental group was significantly greater than that of the control group，and the internal fistula formation time of experimental group was shorter than that of the control group with P<0.05. Conclusion The Chinese herbal fumigation combined with papaya wine wet dressing clinically in treating patients with fistulization can effectively promote the maturity of fistula，improve the quality of internal fistula，enhance the effect of treatment，and reduce the occurrence of internal fistula occlusion.

[Key words] Papaya wine；Arteriovenous fistula；Traditional Chinese fumigation；Internal fistula maturation

動静脉内瘘是肾病终末期者临床行血液透析治疗首选的长期血管通路，其使血液透析能够快速、有效地进行，同时待患者血管通路成熟后，可长期使用，有效提高治疗效果[1]。随着血液透析人群结构变化，患者合并糖尿病、高血脂等疾病情况增多，老年者人数上升，造成营养不良、血管中层钙化、动脉粥样硬化等不良因素增多动，使造瘘成功率降低[2]。同时目前临床尚未有其他更好的血管径路可取代，因此如何提高患者内瘘成功率得到临床医师的关注[3]。有学者提出使用中药熏洗、木瓜酒湿敷，有疏通血管、消炎止痛、促使内瘘早期成熟效果[4]。本研究观察42例行动静脉内瘘成形术者，采用中药熏洗联合木瓜酒湿敷，内瘘成熟情况，现报道如下。

1 资料与方法

1.1 一般资料

以……