腹膜透析治疗在老年慢性肾脏病5期合并心力衰竭患者中的应用效果

Application effect of peritoneal dialysis in the treatment of elderly patients with chronic kidney disease stage-5 complicated with heart failure

目的探讨腹膜透析治疗在老年慢性肾脏病5期合并心力衰竭患者中的应用效果。方法选取2018年7月~2019年9月本院收治的80例老年慢性肾脏病5期合并心力衰竭的患者作为研究对象,通过单盲法将其分为对照组和实验组,每组各40例。其中对照组给予常规强心、利尿、血液透析等治疗,实验组在此基础上,进行腹膜透析治疗。比较比两组患者B型脑钠肽(BNP)水平、心功能指标、肾功能指标及生活质量。结果治疗后,实验组BNP水平低于对照组,差异有统计学意义(P<0.05)。实验组左室射血分数(LVEF)高于对照组,左室舒张末期内径(LVEDD)、左室收缩末期内径(LVESD)短于对照组;且肾功能指标[血肌酐(SCr)、尿素氮(BUN)]均低于对照组,差异有统计学意义(P<0.05)。经治疗后,实验组生活质量(WHOQOL-BREF)评分高于对照组,差异有统计学意义(P<0.05)。结论老年慢性肾脏病5期合并心力衰竭患者采用腹膜透析治疗可降低其BNP水平,改善患者心功能及肾功能,提高其生活质量。

Objective To investigate the effect of peritoneal dialysis in the treatment of elderly patients with chronic kidney disease stage-5 complicated with heart failure.Methods A total of 80 elderly patients with chronic kidney disease stage-5 complicated with heart failure who admitted in our hospital from July 2018 to September 2019 were selected as the study subjects,and they were divided into control group and experimental group according to single blind method,with 40 cases in each group.The control group was given routine treatment with cardiotonics,diuretics and hemodialysis,and the experimental group was treated with peritoneal dialysis based on control group.The B-type natriuretic peptide(BNP),cardiac function indexes,renal function indexes and quality of life were compared between two groups.Results After treatment,the level of BNP in experimental group was lower than that in control group,the difference was statistically significant(P<0.05).The left ventricular ejection fraction(LVEF)in experimental group was higher than that in control group,the left ventricular end diastolic diameter(LVEDD)and left ventricular end systolic diameter(LVESD)in experimental group were shorter than those in control group;the renal function indexes(serum creatinine[SCr],blood urea nitrogen[BUN])in experimental group were lower than those in control group,the differences were statistically significant(P<0.05).After treatment,the score of World Health Organization quality of life scale-brief form questionnaire(WHOQOL)in experimental group was higher than that in control group,the difference was statistically significant(P<0.05).Conclusion Peritoneal dialysis in treatment of elderly patients with chronic kidney disease stage-5 complicated with heart failure can decrease the level of BNP,improve cardiac function and renal function,and increase the quality of life.