腹膜透析治疗小儿先天性心脏病术后急性肾功能衰竭

Peritoneal dialysis for acute renal failure following cardiac surgery of children with congenital heart disease

目的 :探讨腹膜透析 (PD)对小儿先天性心脏病 (先心病 )术后急性肾功能衰竭 (ARF)的治疗效果。方法 :对 36例先心病术后 ARF行 PD治疗患儿的临床资料作回顾性调查。 结果 :全组经 PD治疗后的病死率为 30 .6 % ,其中单纯 ARF的病死率 12 .5 % ,显著低于合并其他系统器官衰竭组的 45 % (P<0 .0 5 )。PD3～ 30 d内肾功能恢复 ,其中 1～ 2 d内血 K+恢复正常 ,2～ 5 d内血碳酸氢根 (HCO3- )恢复正常 ,4～ 6 d内血尿素氮下降 49.2 % ,血肌酐下降 42 .6 %。 结论 :对小儿先心病术后ARF及早进行 PD具有较好的治疗效果。

Objective: To evaluate the therapeutic effect of peritoneal dialysis(PD) for acute renal failure following cardiac surgery in children with congenital heart disease. Methods: Retrospective data from 36 children with ARF who underwent cardiac surgery were analyzed. Results: Case fatality rate was 30.6% in patients undergoing PD, and 12.5% in patients with pure ARF, both significantly lower than that in those associated with other failing organs (45%, P <0.05). Patients recovered within 3 to 30 days of PD,whose blood potassium declined to normal within 1 2 days, (HCO 3 -)declined to normal within 2 5 days, BUN and Cr declined by 49.2% and 42.6% respectively within 4 6 days of PD. Conclusion: PD has a good therapeutic effect for ARF following cardiac surgery in children with congenital heart disease. [