腹膜透析治疗小儿心脏术后急性肾功能不全的疗效及其对患者血清学指标的影响

Clinical effect of peritoneal dialysis in the treatment of children with acute renal insufficiency after heart surgery and its influence on serological indicator

目的分析腹膜透析治疗小儿心脏术后急性肾功能不全的疗效及其对患者血清学指标的影响。方法选择2011年12月至2014年12月间在本院因先天性心脏病接受手术治疗,且术后均出现急性肾功能不全的患儿48例作为研究对象,按照随机数表法将所有患者分为观察组和对照组各24例,分别接受腹膜透析治疗和接受常规治疗,比较两组患儿的肾功能指标、血电解质水平、炎症因子水平等差异。结果 (1)观察组患儿治疗后的血肌酐(Cr)、尿素氮(BUN)、尿β2微球蛋白(β2MG)、24 h尿蛋白(PRO)水平明显低于对照组,差异均具有统计学意义(P<0.05);(2)观察组患儿治疗后的血K+水平低于对照组,Ca2+、HCO3-水平高于对照组,差异均具有统计学意义(P<0.05);(3)观察组患儿治疗后的超敏C反应蛋白(hs-CRP)、肿瘤坏死因子-α(TNF-α)、白介素-6(IL-6)水平明显低于对照组,差异均具有统计学意义(P<0.05)。结论腹膜透析可以有效改善心脏术后急性肾功能不全患儿的肾功能,优化血清电解质及炎症因子水平。

Objective To analyze the clinical effect of peritoneal dialysis for treating children with acute renal insufficiency after heart surgery and its influence on serological indicators. Methods Forty-eight children received surgery for congenital heart disease and appeared acute renal insufficiency after surgery in our hospital from December 2011 to December 2014 were collected as research subjects. The patients were divided into observation group（treated with peritoneal dialysis） and control group（treated with conventional therapy） according to random number table, with 24 cases in each group. Then renal function indexes, blood electrolyte levels, inflammatory factors levels of two groups were compared. Results（1） Creatinine（Cr）, blood urea nitrogen（BUN）, β2-microglobulin（β2MG）, 24-hour urinary protein（PRO） levels of observation group after treatment were significantly lower than those of control group, and the differences were statistically significant（P〈0.05）.（2） K＋level of observation group after treatment was significantly lower than that of control group, while Ca2 ＋, HCO3-levels were significantly higher than control group. The differences had statistical significance（P〈0.05）.（3） High sensitivity C-reactive protein（hs-CRP）, tumor necrosis factor-α（TNF-α）, interleukin-6（IL-6） levels of observation group after treatment were significantly lower than those of control group（P〈0.05）. Conclusion Peritoneal dialysis can improve the renal function of children with acute renal dysfunction, optimize serum electrolyte and inflammatory factors level.