Effects of high dose urokinase continuous infusion treatment on thrombosis in permanent central venous catheters for hemodialysis

Abstract

Objective To observe the effect of high dose urokinase continuous infusion treatment on thrombosis in permanent central venous catheters( CVC) for hemodialysis.Methods A prospective randomized controlled study was performed,78 hemodialysis patients with thrombosis caused by CVC were studied,Among them,45 patients were treated with 125 000 U urokinase continuous infusion for 6 h( treatment group),and 33 patients were treated with 5000 U/ml urokinase intra-catheter dwelling-lock thrombolysis regimen ( control group).Lumen patency,side effects and catheter thrombus reoccurrence were assessed and compared between the two groups after treatment.Results In treatment group,thrombolytic successful rate of arterial end was 88.2％,that of venous end was 95.7％,and the total successful rate was 91.2％ ; in control group,thrombolytic successful rate of arterial end was 76.0％,that of venous end was 75.0％,and the total successful rate was 75.6％ ; The total successful rate of thrombolysis was significantly higher in treatment group than that in controll group( P ＜ 0.05).After the success of thrombolytic therapy,followed-up for 3 months,the incidence of catheter malfunction in treatment group ( 11.5％ ) was significantly lower than that in control group (35.5％ ).Conclusions The effect of high dose urokinase continuous infusion thrombolysis technique is better than intra-catheter dwelling-lock thrombolysis regimen on permanent CVC for HD.And the incidence of catheter malfunction was lower,is worthy to be popularized. Key words: Hemodialysis; Intravenous indwelling catheter; Thrombosis; Urokinase