腹膜透析治疗36例急性肾损伤患者的疗效分析  

The therapeutic effect of peritoneal dialysis on 36 patients with acute kidney injury

作　　者：孙柯 王光腾 梅长林[1] SUN Ke;WANG Guangteng;MEI Chang-lin(Department of Nephrology,Changzheng Hospital,Second Military Medical University,Kidney Institute of PLA,Shanghai,200003,China;The Ninth Team of Third Brigade,Basic Medical College,Second Military Medical University,Shanghai 200433,China)

机构地区：[1]第二军医大学长征医院肾内科解放军肾脏病研究所,上海200003 [2]第二军医大学基础医学院三大队九队,上海200433

出　　处：《中国血液净化》2019年第4期223-225,共3页Chinese Journal of Blood Purification

基　　金：国家自然科学基金(81670612);上海市重中之重临床重点学科(2017ZZ02009)

摘　　要：目的探讨腹膜透析对急性肾损伤的疗效。方法回顾分析采用腹膜透析法治疗的36例急性肾损伤患者的临床资料,对比透析前后患者血压、尿量及血液中K+、HCO_3^-、血肌酐、尿素氮等临床及生化指标变化,分析腹膜透析治疗急性肾损伤的安全性及有效性。结果本组36例患者中治愈10例(27.8%),继续腹膜透析7例(19.4%),死亡10例(27.8%),9例转为血液透析治疗(25%),肾功能平均2～25d恢复。经腹膜透析治疗后,迅速纠正了高钾血症、高血压及急性心力衰竭、尿毒症症状得到明显的好转,血液生化检查尿素氮由透析前平均(40.9±16.1)mmol/L降至(20.4±8.5)mmol/L,血肌酐由透析前平均(1010.3±148.6)μmol/L降至(435.2±45.2)μmol/L,透析前后K^+、HCO_3^-、Na^+、Ca^(2+)、P水平比较差异具有统计学意义(t值分别为8.613,12.783,8.05,4.445,3.487,P值分别为0.021,0.015,0.028,0.037,0.031)。结论腹膜透析对于急性肾损伤的治疗具有简单易行、操作简便、无需抗凝、对血流动力学影响小、治疗费用较低等优点,值得临床一线推广。Objective To investigate the therapeutic effect of peritoneal dialysis(PD)on acute kidney injury(AKI)patients.Methods The clinical data of 36 AKI patients treated with PD were retrospectively analyzed,and their clinical data and biochemical indexes including blood pressure,urine volume,and serum K+,HCO3-,creatinine(Scr)and urea nitrogen(BUN)were compared before and after PD.The safety and effectiveness of PD for the treatment AKI were then analyzed.Results Of the 36 patients,10(27.8%)were cured,7 patients(19.4%)continued to be treated with PD,10 patients(27.8%)died,and 9 patients(25%)were changed to hemodialysis.Patients'kidney function recovered within 2~30 days.After PD,hyperkalemia,hypertension,acute heart failure and uremia symptoms were quickly corrected.The average urea BUN decreased from 40.9±16.1mmol/L to 20.4±8.5mmol/L and the average Scr decreased from 1010.3±148.6μmol/L to 435.2±45.2μmol/L.The changes of serum K^+,HCO3^-,Na^+,Ca^2+and P levels before and after PD were statistically significant(t=8.613,12.783,8.05,4.445 and 3.487,respectively;P=0.021,0.015,0.028,0.037 and 0.031,respectively).Conclusion PD has the advantages of easy and simple operation,no anticoagulation,little influence to hemodynamics and low medical expenses.Therefore,it is valuable to be widely used clinically.

关 键 词：腹膜透析 急性肾损伤 疗效 

分 类 号：R459.5[医药卫生—治疗学]