5例小儿复杂先心病术后急性肾衰临床观察

Outcome of treatment of acute renal failure following cardiac surgery in children with complex congenital heart disease

目的观察腹膜透析(PD)对复杂先心病术后急性肾衰(ARF)患儿的临床疗效。方法对5例复杂先心病术后出现ARF患儿实施PD,观察治疗前后K+、肌苷(Cr)、尿素氮(BUN)及HCO3-等的变化。结果经PD治疗2～10d患儿全部存活,PD48h后与PD前相比,各项观察指标均具有统计学差异(P<0.05),PD结束后除BUN和平均动脉压(MAP)外,其他观察指标均具有显著性差异(P<0.01),纠正酸中毒和高钾血症效果优于Cr和BUN的清除。结论 PD是治疗小儿复杂先心病术后ARF有效方法,尽早PD是治疗成功关键。

Aim To observe the therapeutic effect and safety of treatment of acute renal failure （ARF） following cardiac surgery in children with complex congenital heart disease by peritoneal dialysis （PD）. Methods There 5 children with ARF following open heart surgery using cardiopulmonary bypass （CPB）were treated by PD.The levels of K＋, plasma ereatinine （Cr）, blood urea nitrogen （BUN） and HCO3- and so on were compared before and after treatment. Results The effective rate of the treatment was 100% ,no death occurred. The effect of treatment of acidosis and hyperpotassium was better than cleareance of Cr and BUN. Conclusion The method is simple, rapid, accurate and reliable for ARF related to cardiac surgery in children with complex congenital heart disease.