Azadbakht Morteza, Razian Azadeh, Pooria Ali, Hadian Babak
Department of Surgery, School of Medicine Lorestan University of Medical Sciences Khorramabad Iran.
Student of Research Committee Lorestan University of Medical Sciences Khorramabad Iran.
Health Sci Rep. 2024 May 9;7(5):e2057. doi: 10.1002/hsr2.2057. eCollection 2024 May.
One of the complications of using catheters is the occurrence of thrombosis, which can be dangerous for patients. The main objective of this study is to compare the effect of heparin, reteplase, and taurolock in the prevention of thrombosis in hemodialysis catheters.
The present study is a clinical trial, in which the effect of three drugs, heparin, reteplase, and taurolock, in the prevention of thrombosis in hemodialysis catheters, has been investigated. The research units were studied in two intervention and control groups. The stratified random allocation method was used to assign patients to five groups (control, Heparin 50, Heparin 1000, reteplase, and taurolock), with strata based on the patient's age (20-70 years), gender, and duration of dialysis. Within each stratum, patients were also assigned to groups using the randomized block permutation method and a random number table tool. To prevent bias, this study is triple-blinded. This means that the patient, the thrombosis assessor, and the statistical analyst are unaware of the type of intervention received by the patient.
Gender ( < 0.999), age distribution ( = 0.774), and duration of dialysis ( = 0.875) showed no statistically significant relationship with thrombosis. However, significant differences were observed among the five groups regarding thrombosis incidence. The relative risk of thrombosis in the Heparin 50, Heparin 1000, reteplase, and taurolock groups compared to the control group was 92.5%, 92.2%, 98.2%, and 89% lower, respectively.
Our study underscores the efficacy of heparin, reteplase, and taurolock in preventing thrombosis in hemodialysis catheters. While all three drugs demonstrated efficacy, the Heparin 50 group exhibited the highest relative risk reduction. These findings suggest that heparin, particularly at a low dose, should be considered a standard prophylactic treatment in hemodialysis patients.
使用导管的并发症之一是血栓形成，这对患者可能是危险的。本研究的主要目的是比较肝素、瑞替普酶和陶洛克在预防血液透析导管血栓形成方面的效果。
本研究是一项临床试验，研究了肝素、瑞替普酶和陶洛克这三种药物在预防血液透析导管血栓形成方面的效果。研究对象被分为两个干预组和对照组。采用分层随机分配方法将患者分为五组（对照组、肝素50组、肝素1000组、瑞替普酶组和陶洛克组），分层依据患者年龄（20 - 70岁）、性别和透析时长。在每个分层内，还使用随机区组排列法和随机数字表工具将患者分配到各组。为防止偏倚，本研究采用三盲法。这意味着患者、血栓评估者和统计分析人员均不知道患者接受的干预类型。
性别（<0.999）、年龄分布（=0.774）和透析时长（=0.875）与血栓形成无统计学显著关系。然而，五组之间在血栓形成发生率方面存在显著差异。与对照组相比，肝素50组、肝素1000组、瑞替普酶组和陶洛克组血栓形成的相对风险分别降低了92.5%、92.2%、98.2%和89%。
我们的研究强调了肝素、瑞替普酶和陶洛克在预防血液透析导管血栓形成方面的疗效。虽然这三种药物均显示出疗效，但肝素50组的相对风险降低幅度最大。这些发现表明，肝素，尤其是低剂量肝素，应被视为血液透析患者的标准预防性治疗药物。
