婴幼儿重症先天性心脏病术后腹膜透析应用  

Peritoneal dialysis after surgery for severe congenital heart diseases in infants and young children

作　　者：钟志敏[1] 曹永科[1] 李小芳[1] 谢翠贤[1] 刘超[1] 

机构地区：[1]高州市人民医院心外科,525200

出　　处：《国际医药卫生导报》2011年第9期1032-1035,共4页International Medicine and Health Guidance News

摘　　要：目的探讨腹膜透析（PD）对婴幼儿体外循环心脏手术后的治疗效果及其对术后早期血流动力学的影响以及最佳时机：方法回顾分析2008年1月-2010年12月在我院行重症先天性心脏病手术后婴幼儿需要PD55例患者，平均（1．6±0．8）岁。应用外科手术置入腹膜透析管，同时予以其他综合治疗，包括强心利尿、呼吸支持等。结果PD治疗4h后，血清即和HCO3^-得到纠正，BUN、Ser下降，尿量增多。急性肾损伤4h内开始PD患者治愈率85．29％，PD时间平均（25．05±16．36）h；4h后PD患儿治愈率61．90％，PD时间平均（49．05±22．67）h。对比4h内开始PD治疗较4h后PD治疗患者恢复时间及死亡率比较差异有显著性（P〈0．05，0．01）。结论婴幼儿先天性心脏病术后并发低心排、心力衰竭、急性肾功能不全时。Objective To explore the efficacy of peritoneal dialysis （PD） for 55 infants and young children with acute kidney injury, after cardiac surgery and to assess the effect of PD on hemodynamics and the optimal timing of PD. Methods The data on 55 infants and young children aged 9 days to 3 years [average （ 1.6 ± 0.8 ） years] who had been hosptialized from January 2008 to December 2010 after cardiac surgery eomplicaled with acute renal insnffieiency were retrospectively analyzed. All the patients received peritoneal dialysis logether with other comprehensive treatments including diuretics and respiratory support. Results After 4-hour dialysis, serum levels of K^＋ and HCO3 were corrected and levels of BUN and Scr declined. The curative rate was 85.29% in those with therapy started within 4 hours of acute renal injury, and the average PD duralion was （ 25.05± 16.36 ）h, with a statistical significanee（ P〈 0.05 and P〈 0.01 ）, as compared with a curative rate of 61.90% and average PD duration of （ 49.05 ± 22.67 ） in those who received treatment 4 hours later. Conclusions As pediatric patients occurs low cardiae oalput, heart failure, and acu｜e renal failure, early application of peritoneal dialysis is of active significance in improving prognosis.

关 键 词：先天性心脏病手术 婴幼儿 腹膜透析 急性肾损伤 

分 类 号：R726[医药卫生—儿科]