小儿血液透析和滤过的特点及指征  

The characteristic and indications of children′s hemodialysis and filtration

作　　者：李翠华[1] 栾江威[2] 杨杏鲜[2] 王旭[2] 李冬云[2] 张彩霞[2] 熊嗣玉[2] 

机构地区：[1]武汉大学医学院,430016 [2]武汉市儿童医院

出　　处：《实用儿科临床杂志》2002年第1期23-24,共2页Journal of Applied Clinical Pediatrics

摘　　要：目的探讨小儿血液透析(HD)及血液透析并滤过(HDF)的特点及指征。方法采用预防性透析,对31例因各种原因导致的肾功能衰竭、药物或毒物中毒及多器官功能障碍综合征(MODS)的患儿进行了99例次的HD及9例次的HDF。结果肾功能恢复正常22例,好转7例,死亡2例。并发症少,其中低血压9.17%,失衡综合征2.75%。结论小儿HD及HDF成功的关键是要遵循小儿生理特点,考虑透析指征,根据尿素清除率与血流速度曲线调节血流量及时间,并对急性肾功能衰竭进行预防性透析,对高度水肿、尿毒表现严重、血液动力学不稳定及MODS儿行HDF。Objective To investigate the characteristic and indications of children′s hemodialysis(HD), hemodialysis and filtration(HDF).Methods Precautionary hemodialyses of 99 times HD or for 9 times HDF were given to 31 children with renal failure resulted from kinds of factors, such as toxicosis of medicine or poison, or multiple organ dysfunction syndrome(MODS).Results There were 22 cases whose renal function were fully recovered, 7 cases improved, and 2 cases dead (having no direct relation with HD), with fewer complications, hypotension (only 9.17 % ) and disequilibrium syndrome ( 2.75 %).Conclusions The key to succeed in HD depends on the physiological characteristic of children to select the indications of HD, according to the velocity of the blood flow and time to adjust the urea excretion ratio and the curve of the blood flow′s velocity. At the same time, precautionary HD should be given to those patients who have acute renal failure and HDF was employed to those who had high edema, severe uraemia , variable hemodynamics or MODS.

关 键 词：血液透析 滤过 肾功能衰竭 儿童 透析指征 

分 类 号：R459.5[医药卫生—治疗学]