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| Analysis of Anticoagulant Therapy and Thrombotic Complications in Different Vascular Pathways in Patients Undergoing Maintenance Hemodialysis |
| ZHANG Wen-qiang, SHI Zhu-mei |
| Hospital of Traditional Chinese Medicine of LuZhou, SiChuan Province 646000 |
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Abstract 【Objective】To explore the selection of vascular access and incidence of related complications in patients with maintenance hemodialysis (MHD) and analyze the conditions of anticoagulant therapy.【Methods】A total of 88 patients with MHD in our hospital were divided into long-term indwelling central venous catheter group (CVC, n=10) and autologous internal arteriovenous fistula group (AVF, n=78). The status of anticoagulant therapy and incidence of complications were compared between the two groups.【Results】①Most of the patients who chose AVF pathway were patients whose primary disease was glomerulonephritis, while most patients who chose CVC pathway were female and diabetic patients. The total duration of hemodialysis in the AVF group was longer than that in the CVC group (P<0.05). ②In the CVC group, the proportion of patients using low molecular weight heparin (LMWH) anticoagulant was higher than that in the AVF group (P<0.05), but there was no significant difference in the dose of anticoagulant between the two groups (P>0.05). ③The incidence of thrombotic complications in the CVC group was higher than that in the AVF group (P<0.05). There was no significant difference in the incidence of bleeding complications between the two groups (P>0.05). The incidence of thrombosis in AVF group was significantly lower than that in CVC group (P<0.05). ④The dosage of anticoagulants of patients with thrombotic complications in the two groups was higher than that of patients with bleeding complications (P<0.05).【Conclusion】The incidence of thrombotic complications is higher in MHD patients with CVC vascular access. Anticoagulant therapy is based on LMWH. However, the dose and standard of drug use are not so good and the anticoagulant therapy needs to be further standardized.
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Received: 19 May 2017
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2018, Vol. 35 
