改良腹膜透析治疗急性肾衰竭

Modified Peritoneal Dialysis Treats Acute Renal Failure in Children

目的探索适合儿童患者、操作简单的腹膜透析(PD)法。方法不同年龄段患儿选用不同型号气管导管,刺侧孔及消毒后代替PD管,采用深静脉置管装置行床边穿刺置管,PD液分别从两个不同通路流入、流出腹腔。结果经此法治疗21 例急性肾衰竭(ARF)患儿虽有5例死于DIC或MOSF,但水肿均渐消退,循环、呼吸好转,尿量增加,无1例发生腹膜炎和腹壁渗漏,血清Scr、BUN、尿酸(UA)、K+、CO2-CP分别从PD前(424±133)μmol/L、(41 5±12.6)mmol/L、(764±187)μmol/L、(6.7±2.1)mmol/L、(14.5±3.7)mmol/L降至PD结束时(166±37)μmol/L、(8.9±3 1)nwnol/L、(350±74)μmol/L、(3.7±0.4)mmol/L、(23 0±1.8)mmol/L,相差均非常显著。结论以气管导管或导尿管代替PD管,床边穿刺置管行PD是一种安全、有效的方法。

Objective To explore a kind of modified peritoneal dialysis (PD) adapt for acute renal failure (ARF) in children. Methods After punctured many pinholes in tail end and sterilized by ethylene oxide the ID 2. 5 tracheal tube and urinary catheter were used as PD - catheter for children. The tracheal tube or urinary catheter was placed in abdomen with Seldinger's techniques Then the PD was carried out in the way that dialysis solution passing in and out of abdomen in two different pipelines Results The edema, circulation and respiration of the 21 children with ARF were improved after PD in this way and the urine quantity increased too, although 5 of them died of D1C and MOSF. No peritonitis or leakage of PD solution was taken place. The Scr.BUN,UA,K + ,CO2- CP of the chidren were decreased from(424± 133)μmol/L,(41.5± 12 6) mmol/L, (764 ± 187) μmol/L,(6 7 ±2. 1) mmol/L, (14 5 ± 3.7) mmol/L before PD to( 166±37) μmot/L,(8.9±3 1) mmol/L,(350±74) μmol/L,3.7±0 4 mmol/L,(23.0± 1. 8) μmol/L.Conclusion Tracheal tube or urinary catheter may be used as PD- catheter for ARF in children.