腹膜透析治疗心脏瓣膜替换术后急性肾功能衰竭(附39例报告)  

Peritoneal dialysis of 39 patients with acute renal failure following heart valve replacement

作　　者：方敏华[1] 朱家麟[1] 郝家骅[1] 徐志云[1] 梅举[1] 张宝仁[1] 

机构地区：[1]第二军医大学长海医院胸心外科

出　　处：《第二军医大学学报》1997年第S1期63-65,共3页Academic Journal of Second Military Medical University

摘　　要：目的：分析导致心脏瓣膜替换术后急性肾功能衰竭（ＡＲＦ）死亡的原因，以及影响腹膜透析效果的因素。方法：对３９例心脏瓣膜替换术后ＡＲＦ行腹膜透析治疗患者作回顾性调查。结果：３９例患者均于术后７ｄ内出现ＡＲＦ。单纯ＡＲＦ的死亡率１１．８％（２／１７），显著低于合并其他系统器官衰竭组的４５．５％（１０／２２）（Ｐ＜０．０５）。多器官衰竭中序贯发生组死亡率１４．３％（１／７），显著低于同时发生组的６０％（９／１５）（Ｐ＜０．０１）。死亡率与衰竭系统器官的数目呈正相关（ｒ＝０．９８，Ｐ＜０．０５）。腹膜透析前血肌酐（Ｃｒ）、血Ｃｒ上升速率、尿量影响腹膜透析的效果。结论：腹膜透析是治疗心脏瓣膜替换术后ＡＲＦ一种行之有效的方法，应尽早实施。Objective: To investigate the causes of acute renal failure (ARF) following heart valve replacement and discuss the associated factors affecting the results of peritoneal dialysis. Methods: Retrospective data from 39 patients with ARF following heart valve replacement undergoing peritoneal dialysis were analyzed. Results: ARF in 39 patients occurred during 7 d after operation. The mortality (11.8%) in patients with pure ARF was significantly lower than that (45.5%) in those associated with other failing organs(P<0.05). The mortality (14.3%) of multiple systems organs failure which occurred sequentially was lower as compared with those(60%) occurred simultaneously, and the mortality correlated positively with the number of failing organs. The factors, including blood creatinine(Cr), rate of increasing blood Cr and urine output before peritoneal dialysis , affected the results of peritoneal dialysis. Conclusion: Peritoneal dialysis is a useful method to treat ARF following heart valve replacement, and had better be used as early as possible.

关 键 词：人工心脏瓣膜 肾功能衰竭急性 腹膜透析 

分 类 号：R654[医药卫生—外科学]