腹膜透析治疗小儿先天性心脏病术后急性肾损伤的疗效观察  

Therapeutic effects of peritoneal dialysis on acute renal injury in postoperative children with congenital heart disease

作　　者：莫基斌 陈瑜[2] Mo Jibin;Chen Yu(Department of Critical Care 4,Fujian Provincial Hospital,Fuzhou 350001,China;Department of Cardiovascular Surgery,Fujian Provincial Hospital,Fuzhou 350001,China)

机构地区：[1]福建省立医院重症医学四科,福州350001 [2]福建省立医院心血管外科,福州350001

出　　处：《创伤与急诊电子杂志》2020年第1期19-22,共4页Journal of Trauma and Emergency(Electronic Version)

摘　　要：目的探讨腹膜透析对先天性心脏病术后出现急性肾损伤患儿的治疗效果。方法选取2015年10月至2019年10月入住福建省立医院心血管外科患儿22例,均因先天性心脏病行手术治疗,术后因急性肾损伤行腹膜透析,监测并比较腹膜透析前后不同时间点的代谢指标变化,包括血钾、实际碳酸氢盐、血乳酸、血尿素氮、血肌酐的浓度以及尿量、每周期超滤量。结果血钾、实际碳酸氢盐、血乳酸、血尿素氮、血肌酐浓度以及尿量、每周期超滤量在腹膜透析前后不同时间点之间差异均有统计学意义(P<0.05)。随着腹膜透析治疗,血钾、血乳酸、血尿素氮、血肌酐浓度呈下降趋势,尿量及每周期超滤量呈增多趋势,实际碳酸氢盐浓度在腹膜透析后24h达到高峰。结论腹膜透析可以通过逐步排出多余水分及代谢废物、纠正高钾血症及代谢性酸中毒,从而改善先天性心脏病术后急性肾损伤患儿的内环境并促进其肾功能恢复,值得临床应用。Objective To investigate the therapeutic effect of peritoneal dialysis on children with acute kidney injury after operation of congenital heart disease.Methods Twenty-two children were admitted to the hospital from October 2015 to October 2019.All of them were treated by operation because of congenital heart disease,and peritoneal dialysis was performed after operation because of acute kidney injury.The changes of metabolic indexes were monitored and compared at different time points before and after peritoneal dialysis,including the concentration of serum potassium,actual bicarbonate,lactic acid,urea nitrogen,creatinine concentration and the volume of urine and ultrafiltration per cycle.Results The concentrations of blood potassium,actual bicarbonate,lactic acid,urea nitrogen,creatinine concentration and the volume of urine and ultrafiltration were significantly different at different time points before and after peritoneal dialysis(P<0.05).Along with peritoneal dialysis,the concentration of blood potassium,blood lactic acid,urea nitrogen,creatinine showed a decreasing trend,while the volume of urine and ultrafiltration per cycle showed an increasing trend,and the concentration of actual bicarbonate reached a peak 24 h after peritoneal dialysis.Conclusion Peritoneal dialysis can improve the internal environment and promote the recovery of renal function in children with acute kidney injury after operation of congenital heart disease by gradually removing excess water and metabolic waste,as well as correcting hyperkalemia and metabolic acidosis,which is worthy of clinical application.

关 键 词：先天性心脏病 急性肾损伤 腹膜透析 

分 类 号：R726.9[医药卫生—儿科] R726.5[医药卫生—临床医学]