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目的研究PICC血栓性堵管用尿激酶溶栓的最佳再通方法,提高导管再通率,提升患者满意度。方法体外制备108根PICC血栓性堵管导管,分成A组、B组及C组,每组36根,分别用三通法、注射器法、肝素帽法行尿激酶间歇溶栓,同时对15名护士及担任患者角色护士进行上述3种尿激酶间歇溶栓方法的模拟实验,对导管再通率、操作时间、护士操作难度和患者舒适度进行评价。结果 3种溶栓方法导管再通率差异无统计学意义(P>0.05);在操作时间上A组最长,与其他两组相比,差异有统计意义(P<0.01),首次操作和第2次操作C组操作时间均长于B组,经比较,差异均有统计意义(P<0.01);护士操作难度三通法最大,与其他两种操作法相比,差异有统计意义(P<0.05),注射器法和肝素帽法操作难度差异无统计学意义(P>0.05);患者舒适度三通法与其他两种方法相比,舒适度最差,差异有统计意义(P<0.05),肝素帽法舒适度最佳,与其他两种方法相比,差异有统计学意义(P<0.05)。结论肝素帽法是较佳的尿激酶溶栓再通方法。
Objective To study the best recanalization method for thrombolytic embolization of PICC with urokinase thrombolysis to improve the recanalization rate of the catheter and improve patient satisfaction. Methods 108 PICC thrombectomy catheters were prepared in vitro and divided into groups A, B and C, with 36 rats in each group. Thrombolytic therapy with intermittent urokinase was performed by three-way, Nurses and nurses acting as patient nurses performed the above three simulation experiments of intermittent thrombolysis with urokinase to evaluate the recanalization rate, operation time, nurse operation difficulty and patient comfort. Results There was no significant difference in the recanalization rates between the three thrombolysis methods (P> 0.05). The group A was the longest in operation time and the difference was statistically significant compared with the other two groups (P <0.01) The operation time of the second operation in group C was longer than that in group B, and the difference was statistically significant (P <0.01). The three-way method was the most difficult for nurses to operate, and the difference was statistically significant compared with the other two methods (P < 0.05). There was no significant difference in the operation difficulty between the syringe method and the heparin cap method (P> 0.05). Compared with the other two methods, the comfort degree of the three-way method was the worst, the difference was statistically significant (P <0.05) , Heparin cap law comfort best, compared with the other two methods, the difference was statistically significant (P <0.05). Conclusion Heparin cap method is the best urokinase thrombolysis recanalization method.