腹膜透析在婴幼儿心脏手术后急性肾损伤中的应用

Peritoneal dialysis in infants with acute kidney injury after cardiac surgery.

目的探讨腹膜透析(PD)治疗婴幼儿先天性心脏病术后并发急性肾损伤(AKI)的疗效。方法回顾分析21例先天性心脏病术后AKI行PD治疗患儿的临床资料,将其分成存活组及死亡组,观察PD治疗前两组开始透析时间及治疗前后生化指标的变化。结果经PD治疗后患儿血钾、血肌酐及中心静脉压均有改善(P<0.01),死亡组开始腹膜透析时间明显延后(P<0.01)。结论 PD对婴幼儿体外循环心脏手术后AKI有较好的治疗效果,年龄及开始透析时间可影响患儿预后,尽早开始PD治疗有助于降低死亡率。

Objective To investigate the efficacy of peritoneal dialysis （PD） in infants with acute kidney injury （AKI） after cardiac surgery for congenital heart disease. Methods A retrospective analysis was applied to observe 21 infants with congenital heart disease in this study, who suffered from acute kidney injury （AKI） postopera- tive and were treated by PD. All the patients were divided into two groups, which were the survival group and the death group. The serum biochemical parameter was analyzed before and after treatment. Results Serum potassium, serum creatinine and central venous pressure were improved in the survival group as compare with the death group （P〈0.01）, and timing of PD initiation in the death group were significantly later （P〈0.01）. Conclusion The study suggest that PD is an effective measure for AKI secondary to cardiac surgery by cardiopulmonary bypass, and timing of PD initiation is the important factor on prognosis of infants with AKI post-cardiac surgery. PD may attribute to reduce the mortality.