应用全自动腹膜透析机方法对慢性肾衰竭患者透析效果的临床研究

Clinical Study on the Effect of Automatic Peritoneal Dialysis Machine on Dialysis of Patients with Chronic Renal Failure

目的观察应用全自动腹膜透析机方法对慢性肾衰竭患者透析的临床效果,以及联合结肠透析机清洁灌肠技术降低术后腹膜透析并发症发生率的可行性。方法选取2018年5月—2019年5月在吉林市中心医院肾内科行腹膜透析套管针穿刺置管术后的慢性肾衰竭腹透患者60例,随机分为干预组和对照组,干预组:采用全自动腹膜透析机(Automated peritoneal dialysis,APD)联合结肠透析机清洁灌肠技术的30例患者,对照组采用持续非卧床腹膜透析(Continuous ambulatory peritoneal dialysis,CAPD)技术的30例患者。由专业腹膜透析及结肠透析护士进行技术操作,观察两组患者的生化指标、营养参数、临床症状改善情况及相关并发症发生率。结果腹膜透析治疗7 d后,干预组生化指标、营养参数及临床症状均较对照组明显改善,其中治疗后干预组生化指标BUN(12.90±4.56)mmol/L、SCr:(627.00±277.62)μmol/L、P:(1.26±0.28)mmol/L、K:(3.66±0.59)mmol/L;对照组BUN(17.49±5.45)mmol/L、SCr:(883.95±288.59)μmol/L、P:(1.57±0.56)mmol/L、K(4.00±0.55)mmol/L;两组比较,差异有统计学意义(t=3.538、3.515、2.712、2.580,P<0.05);营养参数中干预组白蛋白(30.62±5.30)g/L、血红蛋白(109.90±38.32)g/L、前白蛋白(106.10±26.55)g/L;对照组的白蛋白(27.32±1.60)g/L、血红蛋白(118.39±22.00)g/L、前白蛋白(103.42±24.39)g/L;两组比较差异有统计学意义(P<0.05);干预组术后并发症(腹膜炎、腹胀、腹痛及便秘)发生率较对照组明显降低,差异有统计学意义(P<0.05);其腹壁疝在两组透析方式治疗差异无统计学意义(P>0.05)。结论全自动腹膜透析机联合结肠透析机清洁灌肠方法应用于腹透患者可有效改善患者的临床症状,降低临床并发症发生率,提高患者的生活质量。

Objective To observe the clinical effect of applying automatic peritoneal dialysis machine method on dialysis in patients with chronic renal failure,and the feasibility of combined colon dialysis machine clean enema technology to reduce the incidence of postoperative peritoneal dialysis complications.Methods From May 2018 to May 2019,60 patients with chronic renal failure and peritoneal dialysis who underwent peritoneal dialysis trocar puncture in the Department of Nephrology of Jilin Central Hospital were randomLy divided into an intervention group and a control group:30 patients with Automated peritoneal dialysis(APD)combined with colon dialysis machine clean enema technology,and 30 patients with continuous ambulatory peritoneal dialysis(CAPD)technology in the control group.Professional peritoneal dialysis and colon dialysis nurses performed technical operations to observe the biochemical indicators,nutritional parameters,clinical symptoms and the incidence of related complications in the two groups of patients.Results After 7 days of peritoneal dialysis treatment,the biochemical indexes,nutritional parameters and clinical symptoms of the intervention group were significantly improved compared with the control group,of which the biochemical indexes of the intervention group after treatment BUN(12.90±4.56)mmol/L、SCr:(627.00±277.62)μmol/L、P:(1.26±0.28)mmol/L、K:(3.66±0.59)mmol/L;the control group:BUN(17.49±5.45)mmol/L、SCr:(883.95±288.59)μmol/L、P:(1.57±0.56)mmol/L、K(4.00±0.55)mmol/L,there were differences between the two groups with statistical significance(t=3.538、3.515、2.712、2.580,P<0.05);nutritional parameters Intervention group albumin(30.62±5.30)g/L,hemoglobin(109.90±38.32)g/L,prealbumin(106.10±26.55)g/L;control group albumin(27.32±1.60)g/L,hemoglobin(118.39±22.00)g/L,prealbumin(103.42±24.39)g/L;between the two groups,with statistical significance(P<0.05);postoperative complications rate(peritonitis,abdominal distension,abdominal pain and constipation)was significantly lower than that of the control group(P<0.05),the difference between the two groups was statistically significant(P<0.05);the abdominal wall hernia had no significant difference between the two groups in dialysis treatment,without statistical significance(P>0.05).Conclusion The application of automatic peritoneal dialysis machine combined with colon dialysis machine clean enema method in peritoneal dialysis patients can effectively improve the clinical symptoms of patients,reduce the incidence of clinical complications,and improve the quality of life of patients.