自动化腹膜透析在CKD5期患者紧急起始透析治疗中的疗效观察  

The application of automated peritoneal dialysisin patients with CKD stage 5 requiring urgent-start peritoneal dialysis treatment

作　　者：牛铁明[1] 董庆泽 黄添翼 李岩[1] 于文晴 王欢 NIU Tieming;DONG Qingze;HUANG Tianyi;LI Yan;YU Wenqing;WANG Huan(Department of Nephrology,Shenyang Red Cross Hospital,Shenyang 110013,Liaoning,China)

机构地区：[1]沈阳市红十字会医院肾病科,辽宁沈阳110013

出　　处：《中国现代医生》2024年第28期26-29,共4页China Modern Doctor

基　　金：辽宁省沈阳市卫生健康委科研课题计划项目(2021-017);辽宁省沈阳市科技计划项目(19-112-4-030)。

摘　　要：目的观察自动化腹膜透析(automated peritoneal dialysis,APD)对慢性肾脏病(chronic kidney disease,CKD)5期患者紧急起始透析治疗的临床疗效。方法选取2021年6月至2023年12月于沈阳市红十字会医院行终末期肾病紧急起始腹膜透析的60例患者为研究对象,根据患者采用腹膜透析的方式将其分为APD组和间歇性腹膜透析(intermittent peritoneal dialysis,IPD)组,每组各30例。比较两组患者的肾功能、电解质、甲状旁腺素、炎症因子、营养指标、脑钠肽、血压、尿量、超滤量及不良反应。结果治疗后,两组患者的血肌酐、尿素氮、尿酸、钾、磷、甲状旁腺素、C反应蛋白、白细胞介素-6、脑钠肽、收缩压、舒张压均显著低于本组治疗前,尿量显著多于本组治疗前(P<0.05),APD组患者的血肌酐、尿素氮、尿酸、钾、磷、甲状旁腺素、C反应蛋白、白细胞介素-6、脑钠肽、收缩压、舒张压均显著低于IPD组,超滤量显著多于IPD组(P<0.05);治疗后,两组患者的尿量比较差异无统计学意义(P>0.05)。治疗中未见严重并发症及死亡病例。结论APD安全、有效,是CKD5期患者紧急起始腹膜透析治疗的良好选择之一。Objective To observe the clinical effect of automated peritoneal dialysis(APD)in urgent-start peritoneal dialysis patients with stage 5 chronic kidney disease(CKD).Methods A total of 60 patients with end-stage renal disease who underwent urgent-start peritoneal dialysis in Shenyang Red Cross Hospital from June 2021 to December 2023 were selected as study objects.According to peritoneal dialysis,patients were divided into APD group and intermittent peritoneal dialysis(IPD)group,with 30 patients in each group.Renal function,electrolyte,parathyroid hormone,inflammatory factors,nutritional indexes,brain natriuretic peptide,blood pressure,urine volume,ultrafiltration volume and adverse reactions were compared between two groups.Results After treatment,serum creatinine,urea nitrogen,uric acid,potassium,phosphorus,parathyroid hormone,C-reactive protein,interleukin-6,brain natriuretic peptide,systolic blood pressure and diastolic blood pressure in two groups were significantly lower than before treatment,and urine volume was significantly higher than before treatment(P<0.05).Serum creatinine,urea nitrogen,uric acid,potassium,phosphorus,parathyroid hormone,C-reactive protein,interleukin-6,brain natriuretic peptide,systolic blood pressure and diastolic blood pressure in APD group were significantly lower than those in IPD group,and ultrafiltration volume in APD group was significantly higher than that in IPD group(P<0.05).After treatment,there was no significant difference in urine volume between two groups(P<0.05).No serious complications and death were observed during treatment.Conclusion APD is safe and effective,and is a good choice for urgent-start peritoneal dialysis in stage 5 CKD patients.

关 键 词：自动化腹膜透析 紧急起始腹膜透析 慢性肾脏病 

分 类 号：R459.5[医药卫生—治疗学]