新生儿主动脉弓离断术后肾功能衰竭腹膜透析的护理

Nursing of peritoneal dialysis for rental failure after arcus aortae amputation of newborns

目的:总结新生儿主动脉弓离断术后肾功能衰竭腹膜透析的护理经验,为临床护理工作提供参考。方法:对行主动脉弓离断术后发生肾功能衰竭的10例新生儿进行腹膜透析,透析期间做好透析管道的护理、透析液的更换、透析液的剂量及留腹时间的控制、循环功能的监测以及营养支持等。结果:8例患儿尿量逐渐恢复、肾功能恢复正常且心功能改善顺利恢复出院,2例早产儿在腹膜透析的过程中,肾功能虽然得以恢复,但其心功能却进一步恶化,并发重症肺炎最终导致多器官功能衰竭而死亡。结论:先心病术后发生肾功能衰竭的新生儿应该及时进行腹膜透析。并在护理过程中严密监测循环功能,及时观察透析液量和尿量,准确评估透析效果以便及时对症处理,同时注意保持透析管路通畅,准确记录出入量,纠正水、电解质平衡,保证充分的营养供应。

Objective ： To summarize the nursing experience of peritoneal dialysis for rental failure after arcus aortae amputation of newborns, so as to provide a reference for the clinical nursing work. Methods：Peritoneal dialysis was conducted for 10 newborns with rental failure after arcus aortae amputation, and during dialysis, nursing was given to the dialysis tube, dialysate was replaced, the dosage and abdomen leaving time of dialysate were controlled, cyclic function was monitored and nutrition support was given. Results ： The 8 newborn patients had their urine amount recovering gradually, had normal recovery of rental function and the their cardiac functions were improved and were discharged smoothly; 2 premature infants had recovery of rental function in the process of peritoneal dialysis, but their cardiac functions were further aggravated, with severe pneumonia, and finally they died due to multiple organ fail- ure. Conclusion ： Peritoneal dialysis should be given timely to the newborns with rental function after congenital heart disease operation, and during nursing, the cyclic function should be monitored strictly, and the dialysate and urine amount should be observed timely and the dialysis effect should be evaluated ac- curately for treatment according to the symptoms, and the dialysis tube should be kept unblocked, the intake and output volumes should be recorded accu- rately, water and electrolyte balance should be corrected and full nutrient supply should be guaranteed.