腹膜透析初期不同透析剂量的临床疗效评价  

Clinical Effect of Different Dialysis Doses in Early Stage of Peritoneal Dialysis

作　　者：吴岩[1] 李丹[1] 张静娟[1] 张蓓茹[1] 李德天[1] 

机构地区：[1]中国医科大学附属盛京医院肾内科,辽宁省沈阳市110004

出　　处：《中国全科医学》2010年第20期2218-2220,共3页Chinese General Practice

摘　　要：目的对比腹膜透析初期不同透析剂量对患者临床状况的影响,初步探讨腹膜透析初期的透析方案。方法依据患者每日透析剂量(dialysis dose,DD)不同,将我院腹膜透析3个月的患者分为A、B、C3组,比较3组患者的透析充分性(内生肌酐清除率)、营养状况(血红蛋白、血清清蛋白)、酸碱(碳酸氢根离子)失衡及电解质(钾离子、钙离子、磷离子)紊乱情况。结果与透析剂量较低的A组相比,B、C两组患者的每日透析时间延长,每日尿量有所下降,差异有统计学意义(P<0.05);B组患者的血清清蛋白水平较A组下降,C组患者的血清清蛋白水平较A组升高,3组间比较差异有统计学意义(P<0.05),但B组、C组患者的血清清蛋白水平分别与A组比较,差异均无统计学意义(P>0.05);3组患者在超滤量、血清内生肌酐清除率、血红蛋白水平及血清钾离子、钙离子、磷离子、实际HCO3-水平方面的差异均无统计学意义(P>0.05)。结论在腹膜透析初期,个体化的透析剂量无论在透析的充分性、营养状况以及酸碱、离子代谢等方面都取得了很好的一致性。Objective To compare the effects of different dialysis doses on clinical status in early stage of peritoneal dialysis, to explore a new dialysis program. Methods Patients hospitalized for 3 months were divided, based on daily dialysis dose （DD） , into groups A, B, C. Dialysis adequacy （endogenous creatine clearance rate） , nutritional status （ hemoglobin, serum albumin） , acid base （bicarbonate irons） imbalance and irons （potassium, calcium and phosphate irons） disorders were compared between 3 groups. Results As compared with group A （low DD） , daily DD time prolonged, daily urinary production decreased in groups B, C, the difference was significant （P 〈 0. 05）. The serum albumin level was lower in group B than in group A, higher in group C than in group A （ P 〈 0.05 ） , but group B, C was not significantly different from group A （ P 〉 0.05）. No significant difference was noted in uhrafihration volume, serum creatinine clearance, hemoglobin level and serum potassium, calcium and phosphate irons, actual HCO3- between 3 groups （P 〉0. 05）. Conclusion In early stage of peritoneal dialysis, individualized DD has made a good consistency in dialysis adequacy, nutritional status, pH and iron metabolism.

关 键 词：腹膜透析 透析剂量 透析充分性 营养状况 

分 类 号：R692.5[医药卫生—泌尿科学]