血液透析在治疗小儿急性肾功能衰竭中的应用及护理

Hemodialysis Treatment and Nursing in Children with Acute Renal Failure

目的探讨急性肾功能衰竭（ARF）患儿血液透析（HD）的效果及护理方法。方法对24例年龄11个月至13岁的ARF患儿，按小儿特点施行HD治疗及护理。结果24例中18例ARF患儿在1—3次HD治疗后临床症状逐渐好转，再经2～4次HD治疗后，水肿消退，尿量增加至500-1200ml／d，Cr由245—568μmol／L降至124—265μmol／L，BUN由26．5—52．0mmol／L降至12．5～23．0mmol／L。24例中18例ARF患儿于住院15—30d痊愈出院；4例转为慢性；2例病情危重死于呼吸循环衰竭。结论应用HD治疗小儿ARF应熟练掌握置管技术，密切观察生命体征，加强HD中的监测和护理，可降低HD中并发症的发生。

Objective To investigate the effect of hemodialysis （HD） and nursing in children with the acute renal failure （ARF）. Methods Twenty-four acute renal failure（ARF） children aged from 11 months to 13 years were treated with hemodialysis （HD） and received the nursing cares according to the characteristics of pediatric HD. Results The clinical symptoms were gradually improved in 18 of 24 cases by 1 -3 HD therapy and nursing, and edema disappeared, urine volume increased to 500 - 1200 ml/d,the level of creatinine decreased from 245 - 568 to 124 - 265 μmol/L, the level of urea nitrogen decreased from 26.5 - 52.0 mmol/L to 12.5 - 23.0 mmol/L. They were discharged after treatment for 15 to 30 days. 4 of 24 cases turned for chronic renal failure;2 of 24 cases were in critical condition and died of respiratory and circulatory failure. Conclusion The technique of catheterization plays an important role in HD treatment in children with ARF. The monitoring of vital signs and careful nursing cares in HD can decrease the incidence of complications.