[1]张妍,李学莉.万古霉素联合肝素封管对留置血液透析导管患者导管相关感染风险及生存质量的影响[J].陕西医学杂志,2026,(4):529-533.[doi:DOI:10.3969/j.issn.1000-7377.2026.04.017]
　ZHANG Yan,LI Xueli.The influence of vancomycin combined with heparin for catheter locking on catheterrelated infection risk and quality of life in patients with indwelling hemodialysis catheters[J].,2026,(4):529-533.[doi:DOI:10.3969/j.issn.1000-7377.2026.04.017]
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万古霉素联合肝素封管对留置血液透析导管患者导管相关感染风险及生存质量的影响

《陕西医学杂志》[ISSN:1000-7377/CN:61-1281/TN]

卷:
期数:
2026年4期
页码:
529-533
栏目:
药物与临床
出版日期:
2026-04-05

文章信息/Info

Title:
The influence of vancomycin combined with heparin for catheter locking on catheterrelated infection risk and quality of life in patients with indwelling hemodialysis catheters
作者:
张妍; 李学莉
（宁夏医科大学第二临床医学院,宁夏 银川 750001）
Author(s):
ZHANG Yan; LI Xueli
（Ningxia Medical University Second Clinical Medical College,Yinchuan 750001,China）
关键词:
万古霉素; 肝素; 血液透析; 留置导管; 并发症; 生存质量; 感染风险
Keywords:
Vancomycin; Heparin; Hemodialysis; Indwelling catheter; Complications; Quality of life; Catheterrelated infection
分类号:
R 692.5
DOI:
DOI:10.3969/j.issn.1000-7377.2026.04.017
文献标志码:
A
摘要:
目的：探究万古霉素联合肝素封管对留置血液透析导管患者导管相关感染风险及生存质量的影响。方法：选取慢性肾衰竭患者82例，采用随机数字表法按照1∶1的方式分配成两组患者。肝素组血液透析完毕应用肝素盐水正压封管，混合组血液透析完毕应用万古霉素与肝素盐水混合液正压封管，其余同肝素组。比较两组患者导管透析血流量、导管静脉压、抗凝血酶Ⅲ（ATⅢ）、凝血功能指标、D-二聚体（D-D）、肾功能衰竭生命质量测定量表（QLICD-CRF）评分以及导管相关并发症情况。结果：两组患者透析前导管透析血流量、导管静脉压比较，无统计学差异（均P>0.05）；相较于透析前，两组患者透析1、3、6个月导管透析血流量降低，导管静脉压升高（均P<0.05）；混合组透析3、6个月导管透析血流量高于肝素组，导管静脉压低于肝素组（均P<0.05）。两组患者透析1个月的导管透析血流量、导管静脉压比较，无统计学差异（均P>0.05）。两组患者透析前ATⅢ、D-D比较，无统计学差异（均P>0.05）；相较于透析前，两组患者透析6个月D-D降低，ATⅢ升高（均P<0.05）；两组患者透析6个月ATⅢ、D-D比较，无统计学差异（均P>0.05）。两组患者透析前、透析6个月凝血功能指标比较，无统计学差异（均P>0.05）。混合组导管感染、导管栓塞发生率与肝素组比较，无统计学差异（均P>0.05）。混合组导管相关总并发症发生率低于肝素组（P<0.05）。两组患者透析前肾功能衰竭生命质量测定量表（QLICD-CRF）评分比较，无统计学差异（P>0.05）；相较于透析前，两组患者透析6个月特异模块以及生理、心理、社会功能评分升高，且混合组透析6个月高于肝素组（均P<0.05）。结论：万古霉素联合肝素封管用于留置血液透析导管可保持导管通畅性，降低导管相关总并发症的发生，提高生存质量。
Abstract:
Objective:To observe the effect of vancomycin combined with heparin for catheter sealing on the risk of catheterrelated infection and quality of life in patients with chronic renal failure who have indwelling hemodialysis catheters.Methods：A total of 82 patients with chronic renal failure were enrolled and randomly assigned to two groups in a 1∶1 ratio using a random number table method.The heparin group used heparin saline for positive pressure catheter sealing after hemodialysis,while the mixed group used a mixture of vancomycin and heparin saline for positive pressure catheter sealing after hemodialysis.Other aspects were the same for both groups.The catheter hemodialysis blood flow,catheter venous pressure,antithrombin Ⅲ（A T Ⅲ）,coagulation function indicators,D-Dimer （D-D）,Quality of Life Index for Chronic Renal Failure （QLICD-CRF） score,and catheterrelated complications were compared between the two groups.Results:There was no significant difference in catheter hemodialysis blood flow and catheter venous pressure before hemodialysis between the two groups （all P>0.05）.Compared with before hemodialysis,the catheter hemodialysis blood flow decreased and the catheter venous pressure increased in both groups at 1 month,3 months,and 6 months after hemodialysis （all P<0.05）.The catheter hemodialysis blood flow in the mixed group was higher and the catheter venous pressure was lower than those in the heparin group at 3 months and 6 months after hemodialysis （all P<0.05）.There was no significant difference in catheter hemodialysis blood flow and catheter venous pressure between the two groups at 1 month after hemodialysis （all P>0.05）.There was no significant difference in A T Ⅲ and D-D before hemodialysis between the two groups （all P>0.05）.Compared with before hemodialysis,D-D decreased and ATⅢ increased in both groups at 6 months after hemodialysis （all P<0.05）.There was no significant difference in ATⅢ and D-D between the two groups at 6 months after hemodialysis （all P>0.05）.There was no significant difference in coagulation function indicators before and at 6 months after hemodialysis between the two groups （all P>0.05）.The incidence of catheter infection and catheter embolism in the mixed group was not significantly different from that in the heparin group （all P>0.05）.The total incidence of catheterrelated complications in the mixed group was lower than that in the heparin group （P<0.05）.There was no significant difference in QLICD-CRF score before hemodialysis between the two groups （P>0.05）.Compared with before hemodialysis,the scores of specific modules and physical,psychological,and social functions increased in both groups at 6 months after hemodialysis,and the mixed group was higher than the heparin group at 6 months after hemodialysis （all P<0.05）.Conclusion:Vancomycin combined with heparin catheter sealing for indwelling hemodialysis catheters can maintain catheter patency,reduce the occurrence of total catheterrelated complications,and improve the quality of life.

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备注/Memo

备注/Memo:
宁夏回族自治区自然科学基金资助项目（2019AAC03274）；宁夏医科大学科学研究资助项目（XZ2024039）
更新日期/Last Update: 2026-04-05