早期腹膜透析在儿童重症先天性心脏病术后的临床应用

Clinical application of early peritoneal dialysis in children with severe congenital heart disease after surgery

目的:通过回顾性研究了解早期腹膜透析在儿童重症先天性心脏病术(CHD)后的临床应用价值。方法:选择2004年1月至2017年6月,河北省儿童医院心外科收治的71例重症CHD术后应用腹膜透析患儿,年龄3 d^11岁,中位体质量5.2个月;体质量2~8 kg,中位体质量5.5 kg。2004年至2010年,为传统透析组,腹透开始的时机较晚,适应证较严格;2011年至2017年,为早期透析组,腹透开始的时机较早,适应证适当放宽。对照性研究其生存率、并发症、呼吸机辅助时间及ICU滞留时间。结果:传统透析组23例,15例死亡,早期透析组48例,4例死亡;早期透析组应用腹膜透析后各项指标均有明显改善。结论:早期腹膜透析可提高患儿生存率,缩短呼吸机辅助时间及ICU滞留时间,有益于患儿及家属。

Objective： Objective to investigate the clinical value of early peritoneal dialysis in the treatment of severe congenital heart disease in children. Methods： 71 cases of peritoneal dialysis treated severe congenital heart disease after surgery were selected from January 2004 to June 2017 after the cardiac surgery in Children＇s Hospital of Hebei Province. A phase control study was conducted to study. The patients were aged 3 day-11 years old and weighed 2-8 kg. 2004-2010 in the control group,peritoneal dialysis start late indications strictly,2011-2017 in the experimental group,peritoneal dialysis start time earlier,indications properly relaxed. Comparative study of the survival rate,complications,breathing time and ICU ventilator assisted retention time. Results： In the control group,23 cases were treated,15 cases died. In the experimental group,48 cases were treated,4 cases died. The indicators of the experimental group were better than the control group. Conclusion： Early peritoneal dialysis can improve the survival rate of children,shorten the time of mechanical ventilation and ICU residence time,and be beneficial to children and their families.