改良持续腹膜透析法治疗危重新生儿的临床效果分析

Clinical analysis of modified continuous peritoneal dialysis in the treatment of critically ill neonates

目的:分析改良持续腹膜透析法(CPD)在危重新生儿治疗中的安全性和有效性。方法:分析2019年2月—2021年8月柳州市妇幼保健院新生儿重症监护病房(NI CU)应用改良持续腹膜透析法治疗的11例新生儿临床资料。比较透析前后患儿血肌酐、血钾、血氨、PH值、乳酸、尿量的变化及疾病转归;并观察CPD过程中堵管、渗漏、腹膜炎、坏死性小肠结肠炎等并发症情况。结果:共纳入11例新生儿,存活7例,死亡4例。存活组血钾透析前与透析后分别为(5.83±1.29)mmol/L与(3.45±0.75)mmol/L,尿量分别为(1.68±1.32)mL/kg·h与(5.34±1.65)mL/kg·h,乳酸分别为(12.08±10.05)mmol/L与(1.76±0.59)mmol/L,存活组患儿透析前与透析后比较,水代谢、酸碱平衡得到明显改善,Cr、K+、血乳酸水平明显降低,pH值升高,差异有统计学意义(P<0.05);死亡组上述指标治疗前后比较,差异无统计学意义(P>0.05)。通过两组数据分析显示,使用血管活性药物、4个以上器官功能障碍是影响患儿生存因素。结论:改良持续腹膜透析法在危重症新生儿救治中安全有效,能显著提高临床危重患者救治成功率。

Objective To explore the security and effectiveness of modified continuous peritoneal dialysisin the treatment of critical neonates.Methods Data from 11 neonates were treated with modified continuous peritoneal dialysis in the neonatal Intensive Care Unit(neonatal intensive care unit,NICU)of Liuzhou Maternal and Child Health Hospital from February 2019 to August 2021 cases of Serum creatinine,potassium,ammonia,PH value,lactic acid,urine volume,complications were analyzed.Observe complications such as tube blockage,leakage,peritonitis and necrotic enterocolitis during CPD.Results A total of 11 newborns were included,7 were alive and 4 died.In the surviving group,mmol/L was determined between(5.83±1.29)and(3.45±0.75),respectively,Urinary volume was(1.68±1.32)and(5.34±1.65,respectively),Lactic acid was the(12.08±10.05)and the(1.76±0.59)mmol/L,respectively,After dialysis,blood potassium levels decreased,urine volume increased and lactic ate decreased,statistically significant.The above indicators have also improved in the death group.Two groups of data analysis showed that the use of vasoactive drugs,more than four organ disorders are the factors affecting the survival of children.Conclusion Modified continuous peritoneal dialysis,is able to significantly improve the success rate,is safe and effective in the treatment ofcritical neonates.Prognosis is mainly related to the general basic condition of the children.