Clinical Analysis Of Fistula Embolization In Patients With Coagulation Disorders

Objective:To investigate fistula thrombosis reason of thearteriovenous fistula for vascular access in patients withmaintenance hemodialysis and the clinical analysis of theanticoagulant effect of aspirin.Methods: September2010to October2011in the Second AffiliatedHospital of Chongqing Medical University, Department of Nephrology,arteriovenous fistula for maintenance hemodialysis vascular access line ofthe92patients with end-stage renal failure (ESRD) patients as the researchobject,A prospective randomized single blind controlled, the case groupwere divided into group A and group B according to a random number,each selected46people, group A aspirin enteric-coated tablets (Bayerpharmaceutical company)100mg/d, B,The group was given of VitC100mg/d as a placebo control group. Observe the arteriovenous fistulaembolization action within six months, and detection of plateletaggregation test (PAgT), platelet count (PLT), mean platelet volume (MPV),mean platelet distribution width (PDW), prothrombin time (PT), partialthromboplastin time (APTT), thrombin time (TT), vWF factor, D-dimer, fecal occult blood test.Results: The thrombosis rate of embolization in patients with oralaspirin group A was significantly lower than the oral placebo group B, thedifference was statistically significant (P <0.05). Platelet aggregationactivity of group A and group B compared with normal control groupdeclined, the differences were statistically significant (P <0.05), but nosignificant difference between the two groups (P>0.05). PLT group A andgroup B compared with normal control group declined (P <0.05), but nosignificant difference between the two groups (P>0.05). And no significantchange between the MVP and PDW value three groups, the difference isnot statistically significant (P>0.05). Group A and group B patients withPT, APTT and TT time the two groups compared with normal control groupwere increased (P <0.05) but no significant difference between the twogroups. VWF and D-dimer levels in the group A than in group B decreased,but the two groups compared with the normal control group has increased,the difference was statistically significant (P <0.05). Group A patients withpositive fecal occult blood test was slightly higher than group B, thedifference was statistically significant (P <0.05).Conculation:1.After fistula in maintenance hemodialysis patientsplatelet aggregation activity and platelet counts than normal decline ofvWF factor and D-dimer significantly increased compared with normal,suggesting that patients may also exist thrombosisthe risk of the formation and bleeding tendency.2.After the fistula fistula thrombosis rate in maintenance hemodialysispatients with low-dose aspirin was significantly lower than the placebocontrol group, and long-term anticoagulant effect.3.After fistula in maintenance hemodialysis patients after low-dose aspirincan make platelets and vascular endothelial function exception part of theimprovement, vWF and D-dimer have also been reduced, helping to reducefistula embolism.4.After fistula in maintenance hemodialysis patients in the low-dose aspirinside effects of gastrointestinal bleeding (fecal occult blood test positive rate)is higher than those without oral, suggesting that aspirin may increase thebleeding tendency in patients with, so should be followed up regularlyduring use, prevention of drug side effects that may occur.