自动化腹膜透析对常规腹膜透析患者合并急性心功能不全的治疗效果观察

Effect Observation of Automated Peritoneal Dialysis Treating Routine Peritoneal Dialysis Patients with Acute Heart Failure

目的 分析研究自动化腹膜透析（automated peritoneal dialysis,APD）对已行腹膜透析的慢性肾脏病（chronic kidney disease,CKD）5期患者合并急性心功能不全的治疗效果及优缺点.方法 选择2015年6月—2017年2月收治的6例合并急性心功能不全的腹膜透析患者的临床资料,观察在应用APD治疗前后,患者心功能不全的症状、血清肌酐、血尿素氮（BUN）、血钾、脑利钠肽（BNP）、收缩压等指标的变化.结果 所有患者行APD治疗后心功能不全症状均明显改善.治疗后,患者血肌酐、BUN、BNP以及收缩压均显著低于治疗前,差异有统计学意义（P〈0.05）.两组患者治疗前后血钾差异无统计学意义（P〉0.05）.结论 对于腹膜透析患者,当其出现急性心功能不全时,APD治疗能够有效地改善急性心功能不全症状,增加超滤量,降低血肌酐、BUN、收缩压,同时可以避免临时置管风险,避免抗凝治疗出血风险.

Objective To assess the efficacy, advantage, disadvantage of automated peritoneal dialysis （APD） for acute heart failure in patients who got peritoneal dialysis for the chronic kidney disease stage 5. Methods We collected the clinical data of 6 hospitalized patients with acute heart failure who got peritoneal dialysis from June 2015 to February 2017 and compared the changes of symptoms of heart failure, serum creatinine, urea nitrogen, serum potassium, plasma brain natriuretic peptide, systolic blood pressure before and after APD treatment. Results After treatment, the symptoms of acute heart failure were improved. Serum creatinine, urea nitrogen, plasma brain natriuretic peptide, systolic blood pressure were decreased （P〈0.05） after APD treatment. But serum potassium comparison showed no significant difference （P〉0.05）. Conclusion For peritoneal dialysis patients with acute heart failure, APD can effectively improve the acute heart failure symptoms, increase the ultrafiltration, and reduce serum creatinine, blood urea nitrogen, systolic blood pressure. APD can also avoid the risk of temporary peritoneal dialysis catheter, and avoid the bleeding risk of anticoagulant therapy.