Efficacy of different urokinase thrombolytic methods in the treatment of dysfunction of central venous catheter with polyester sleeve

Objective To explore the clinical strategies and safety of different urokinase thrombolytic methods in the treatment of dysfunction of central venous catheter with polyester sleeve. Methods 30 patients who had had dysfunction of central venous catheter with polyester sleeve (≥1 time/week, altogetrher more than 2 times) in our hospital from January 1, 2018 to September 1, 2019 were selected. All the patients were given regular dialysis 3 times/week, and randomly divided into three groups A, B, and C according to the random number method, with 10 patients each. Another 10 patients who had had a good function of the central venous catheter with polyester sleeve were also enrolled. Group A were given urokinase (100, 000 units) in normal saline (10 ml) that was continuously pumped at a drip speed of 1 ml/h from the arteriovenous end of the catheter, and the last 2 ml was injected into the catheter on the day before dialysis once a week. Group B were given urokinase (100, 000 units) in normal saline (100 ml) that was continuously pumped at a drip speed of 5 ml/min on the day of dialysis once a week; In group C, urokinase (100, 000 units) in normal saline (4 ml) was given to the arteriovenous end of the catheter for thrombolysis in sealing the tube, and a suction was given after 20 minutes on the day of dialysis once a week. One month later, the changes of blood flow and pressure and the occurrence of bleeding events in each group were observed. Results After the thrombolytic therapies, the catheter function was improved in all the three groups. The blood flow volume of group A was greater than those of groups B and C (P<0.01), and the arteriovenous pressure of group A could meet the clinical needs. Conclusion The long-term effect of continuous pumping of small dose of urokinase was better in the treatment of catheter dysfunction. Key words: Urokinase; Thrombolysis therapy; Central venous catheter with polyester sleeve; Hemodialysis