婴幼儿法洛氏四联症矫治术后急性肾功能不全的腹膜透析治疗

Effects of peritoneal dialysis on acute renal dysfunction in infants with tetralogy of Fallot after surgical correction

目的分析评价婴幼儿法洛氏四联症矫治术后急性肾功能不全行腹膜透析术的治疗效果。方法总结我院2007年7月至2013年12月行婴幼儿法洛氏四联症矫治术后出现急性肾功能不全患儿17例病例,均采用腹膜透析术进行治疗,通过比较腹膜透析前、后血清钾离子、肌酐、尿素氮、乳酸水平、Pa O2水平,观察腹膜透析治疗效果及并发症。结果 14例患儿康复,有效率82.4%,死亡3例,病死率17.6%,其中循环功能不全3例,最后死于多器官功能衰竭,5例释放透析液血压骤降,及时综合调整,血流动力学逐渐好转平稳;与腹膜透析前比较,腹膜透析后血清肌酐、尿素氮、乳酸水平及Pa O2均较前明显改善和好转,比较其差异有统计学意义(P<0.05)。结论腹膜透析术治疗婴幼儿法洛氏四联症矫治术后急性肾功能不全有效治愈率达82.4%、设备和操作简单、基层单位值得推广。

Objective To analyze the therapeutic effects of peritoneal dialysis on acute renal dysfunction in infants with tetralogy of Fallot after surgical correction. Methods Seventeen acute renal dysfunction cases of infants with tetralogy of Fallot after surgical correction treated with peritoneal dialysis in the Affiliated Hospital of Zunyi Medical University from July,2007 to December,2013 was summarized. Serum potassium,creatinine,urea nitrogen,lactic acid level and Pa O2 level before and after peritoneal dialysis were detected to evaluate the peritoneal dialysis treatment effects and complications. Results Fourteen infants were recovered with the efficiency rate of 82. 4% and 3 cases died with the mortality rate of 17. 6%,in which 3 cases had the circulation dysfunction and finally died of multiple organ failure and the hemodynamics of 5 cases was timely adjusted and then improved when the release of dialysis fluid caused the decreased blood pressure. Serum creatinine,urea nitrogen,lactate and Pa O2 levels after peritoneal dialysis were significantly attenuated compared with those before peritoneal dialysis（ P〈0. 05）. Conclusion The curative rate of peritoneal dialysis on acute renal dysfunction in infants with tetralogy of Fallot after surgical correction is up to 82. 4% and this method is well worth popularizing in base unit.