腹膜透析治疗小儿先心病术后低心排血量综合征的临床研究(英文)

Clinical study for peritoneal dialysis treating low cardiac output syndrome after surgery in children with congenital heart disease

目的:观察腹膜透析治疗小儿先心病术后低心排血量综合征的疗效果。方法:61例先心病术后并发低心排血量综合征患儿,于腹膜透析前后以心脏超声测定心腔内径、左室射血分数、肺动脉压力变化,另测定中心静脉压、尿量、血气分析指标、血浆脑型利钠肽浓度评估腹膜透析的影响。结果:与治疗前相比,尿量[(203.28±15.81)ml比(989.11±54.72)ml]显著增多,左室射血分数显著提高[(32.94±2.29)%比(51.93±2.79)%];而肺动脉压[(46.72±3.84)mmHg比(34.82±2.92)mmHg]、中心静脉压[(17.27±1.47)cmH2O比(10.41±1.01)cmH2O],血浆脑型利钠肽水平[(5928.71±158.27)ng/ml比(3851.83±128.81)ng/ml]显著下降,P均<0.001,。结论:腹膜透析可有效治疗先心病术后低心排血量综合征,这与其超滤、减轻心脏负担等作用有关。

Objective：To observe the therapeutic effect of peritoneal dialysis on low cardiac output syndrome （LCOS） after surgery in children with congenital heart disease （CHD）.Methods：A total of 6 1 CHD children complicated with LCOS after surgery were selected.Echocardiography was used to measure heart chamber diameter,left ventricular ejection fraction （LVEF）and pulmonary artery pressure etc.before and after peritoneal dialysis;and central venous pressure （CVP）,urine volume,blood gas analysis indexes,plasma brain natriuretic peptide （BNP）concentration were measured to evaluate influence of peritoneal dialysis.Results：Compared with before treatment, there were significant increase in urine volume [（203.28±15.81）ml vs.（989.11± 54.72）ml],LVEF [（32.94± 2.29）% vs.（51.93±2.79）%];and significant reduction in pulmonary artery pressure [（46.72±3.84）mmHg vs. （34.82±2.92）mmHg],CVP [（17.27±1.47）cm H2 O vs.（10.41±1.01）cm H2O]and plasma BNP level [（5928.71±158.27）ng/ml vs.（3851.83± 128.81）ng/ml],P〈0.001 all.Conclusion：Peritoneal dialysis may effectively treat low cardiac output syndrome after surgery in children with congenital heart disease,related with its effect of ultrafiltration and relieve cardiac burden.