持续不卧床腹膜透析治疗小儿肾功能衰竭

Report on the treatment of children with renal failure on continuous ambulatory peritoneal dialysis

目的 观察持续不卧床腹膜透析 (CAPD)治疗小儿急、慢性肾功能衰竭的临床疗效。方法 对确诊为急、慢性肾功能衰竭 ,符合透析指征的 18例患儿行 CAPD治疗。结果 18例肾功能衰竭的患儿进行 CAPD平均透析时间为 34 .5± 8.0天。住院期间存活 16例 ,死亡 2例。 2例慢性肾功能衰竭患儿出院后在家中继续透析 ,其中 1例因中断透析死亡 ;18例血钾于 2 4～ 48小时恢复正常 ,血浆 HCO- 3于 48～ 72小时内恢复正常。血尿素氮、肌酐值经腹膜透析 5～ 10天分别下降 5 2 .5 %和 40 .2 %。尿毒症症状消失或明显减轻。腹膜透析并发症有腹膜炎、透析管引流处腹透液外渗、透析管移位、低钾、高血糖。结论 CAPD在治疗小儿急、慢性肾功能衰竭中安全、有效。具备透析指征者尽早使用 CAPD可以控制体内代谢紊乱 。

Objective The observation of the clinical effects of treatment of acute and chronic renal failure in children on continuous ambulatory peritoneal dialysis (CAPD).Methods Eighteen children with renal failure were treated with CAPD.Results The average time of dialysis of 18 cases on CAPD is 34.5±8.0 days.Sixteen survived during the hospitalzation,two died.Two cases with chronic renal failure continued CAPD at home after discharge from the hospital.One of them stopped CAPD and died.Concentration of serum potassium of 18 cases returned to normal level during the first 24～48 hours of dialysis,carbon dioxide combining power returned to normal level after 48～72 hours.Reduction of serum nitrogen and creatine was respectively 52.2% and 40.2% after 5～10 days of dialysis.Symptoms of uremia disappeared or decreased.Complications included peritonitis,leakage of dialysate at exit site of catheter,catheter displacement hypopotassium and hyperglycemia.Conclusions CAPD is safe and effective in these patients with acute and chronic renal failure.They should be treated by CAPD early to reduce the symptoms of uremia,prevent the complications of uremia.