用气管导管作腹膜透析管治疗儿童急性肾衰竭

Tracheal tubes replace PD-catheters in the peritoneal dialysis of children's acute renal failure

目的腹膜透析(peritonealdialysis,PD)是治疗儿童急性肾功能衰竭(acuterenalfailure,ARF)的有效方法,本研究拟寻找一种合适的PD管代用品,简化置管方法,降低腹膜炎的发生率。方法不同年龄阶段的ARF患儿分别选用2.5、3.0、3.5号的气管导管,经刺侧孔、消毒等处理后代替PD管,用深静脉置管装置,参考Seldinger穿刺法行床边置管,PD液分别从二个不同的通路持续或间断流入、流出腹腔。结果经此法治疗的26例ARF患儿虽有7例死于DIC或MODF,但无一例发生腹膜炎和腹壁渗漏,水肿均逐渐消退,大部分尿量增加。结论在没有合适的商用PD管的情况下,以气管导管代替PD管,床边插管,有一定疗效,值得进一步探讨和推广。

Objective Peritoneal dialysis（PD） is a kind of replacement treatment for acute renal failure （ARF）. We try to find a alternative for common PD-catheter and simplify the method of placing PD-catheters. Methods After punctured many pinholes in end of the thacheal tubes sterilized by ethylene oxide, the tracheal tubes（ID 2.5, 3.0, and 3.5 selected in different ages） were used as PD-catheters for children. Acording to Seldinger Techniques for Catheter Insertion. The tracheal tube served as a effluent way, and in the same time placing another tube（indwelling venous needle or other soft tube）as a inflow way. Then the PD was carried out by two different pipelines. Results After PD in this way, the ARF children had improved circula- tion , respiration and increased urine quantity although seven of them died from DIC and MODF. No one had peritonitis or dialysis solution leaking. Conclusion The tracheal tube may be used as simple PD-catheter when without suitable common PD-catheter. It is effective and worth of advanced discussion and spreading.