中国基层医药
中國基層醫藥
중국기층의약
CHINESE JOURNAL OF PRIMARY MEDICINE AND PHARMACY
2012年
11期
1609-1610
,共2页
梁林宝%程国栋%凌国生%朱春磊
樑林寶%程國棟%凌國生%硃春磊
량림보%정국동%릉국생%주춘뢰
腹膜透析%心脏病
腹膜透析%心髒病
복막투석%심장병
Peritoneal dialysis%Heart disease
目的 探讨复杂先天性心脏病术后腹膜透析(PD)的应用时机.方法 65例复杂性先天性心脏病患儿随机分为A组(33例)与B组(32例),A组术后于使用利尿药效果差或尿量＜0.5ml·kg-1·h-1时即采用PD,B组于尿量＜0.5 ml·kg-1·h-1持续6h后采用PD,观察比较两组患儿的生存效果和PD前后各项指标的变化.结果 PD治疗l-15 d后,65例患儿PD前尿量(1.03±0.43)ml·kg-1·h-1、血钾(5.52±0.94) mmol/L、血尿素氮(19.54±3.73) mmol/L、血肌酐(143.77±42.89) mmol/L,PD后分别为(2.85±0.61)ml· kg-1· h-1、(4.32±0.57) mmol/L、(9.54±3.42) mmol/L、(120.01±49.22)mmol/L,PD前后各项指标变化差异均有统计学意义(t =5.22、3.46、4.89、4.77,均P＜0.05).A组患儿尿量逐渐改善及恢复28例(84.85％),明显优于B组的17(53.12％)(x2=5.18,P＜0.05),A组病死率9.09％ (2/33),明显低于B组的l8.75％ (6/32)(x2=5.32,P＜0.05).结论 PD是复杂先天性心脏病术后并发心、肾功能不全时的有效治疗手段,及早应用临床效果显著.
目的 探討複雜先天性心髒病術後腹膜透析(PD)的應用時機.方法 65例複雜性先天性心髒病患兒隨機分為A組(33例)與B組(32例),A組術後于使用利尿藥效果差或尿量＜0.5ml·kg-1·h-1時即採用PD,B組于尿量＜0.5 ml·kg-1·h-1持續6h後採用PD,觀察比較兩組患兒的生存效果和PD前後各項指標的變化.結果 PD治療l-15 d後,65例患兒PD前尿量(1.03±0.43)ml·kg-1·h-1、血鉀(5.52±0.94) mmol/L、血尿素氮(19.54±3.73) mmol/L、血肌酐(143.77±42.89) mmol/L,PD後分彆為(2.85±0.61)ml· kg-1· h-1、(4.32±0.57) mmol/L、(9.54±3.42) mmol/L、(120.01±49.22)mmol/L,PD前後各項指標變化差異均有統計學意義(t =5.22、3.46、4.89、4.77,均P＜0.05).A組患兒尿量逐漸改善及恢複28例(84.85％),明顯優于B組的17(53.12％)(x2=5.18,P＜0.05),A組病死率9.09％ (2/33),明顯低于B組的l8.75％ (6/32)(x2=5.32,P＜0.05).結論 PD是複雜先天性心髒病術後併髮心、腎功能不全時的有效治療手段,及早應用臨床效果顯著.
목적 탐토복잡선천성심장병술후복막투석(PD)적응용시궤.방법 65례복잡성선천성심장병환인수궤분위A조(33례)여B조(32례),A조술후우사용이뇨약효과차혹뇨량＜0.5ml·kg-1·h-1시즉채용PD,B조우뇨량＜0.5 ml·kg-1·h-1지속6h후채용PD,관찰비교량조환인적생존효과화PD전후각항지표적변화.결과 PD치료l-15 d후,65례환인PD전뇨량(1.03±0.43)ml·kg-1·h-1、혈갑(5.52±0.94) mmol/L、혈뇨소담(19.54±3.73) mmol/L、혈기항(143.77±42.89) mmol/L,PD후분별위(2.85±0.61)ml· kg-1· h-1、(4.32±0.57) mmol/L、(9.54±3.42) mmol/L、(120.01±49.22)mmol/L,PD전후각항지표변화차이균유통계학의의(t =5.22、3.46、4.89、4.77,균P＜0.05).A조환인뇨량축점개선급회복28례(84.85％),명현우우B조적17(53.12％)(x2=5.18,P＜0.05),A조병사솔9.09％ (2/33),명현저우B조적l8.75％ (6/32)(x2=5.32,P＜0.05).결론 PD시복잡선천성심장병술후병발심、신공능불전시적유효치료수단,급조응용림상효과현저.
Objective To investigate the efficacy of peritoneal dialysis(PD) in the children with complex congenital heart disease after surgery.Methods 65 children with complex congenital heart disease were divided into group A(33 cases) and group B(32 cases).Group A was given PD when diuretics or urine output was less than 0.5ml per hour,while group B was given PD when urine output was less than 0.5ml per hour after 6h.The survival effect and indicators of PD before and after treatment were observed.Results The effective rate of group A (84.85％ ) was significantly better than group B ( 53.12％ ) ( x2 =5.18,P ＜ 0.05 ).The fatality rate of group A (9.09％ ) was significantly lower than group B ( 18.75％ ) ( x2 =5.32,P ＜ 0.05 ).The renal function was significantly improved.Urine output increased to the normal level,serum potassium,blood urea nitrogen,serum creatinine concentration were effectively controlled,the changes of indicators had significant differences before and after PD (t =5.22,3.46,46,4.89,4.77,all P ＜ 0.05).Conclusion PD was an effective support method for heart,renal insufficiency after the surgery of complex congenital heart disease,and it had good clinical effect for early application.
