CAJ | 학술논문

目的探讨腹膜透析(PD)对婴幼儿体外循环心脏手术后的治疗效果及其对术后早期血流动力学的影响以及最佳时机.方法回顾分析2008年1月-2010年12月在我院行重症先天性心脏病手术后婴幼儿需要PD 55例患者,平均(1.6±0.8)岁.应用外科手术置入腹膜透析管,同时予以其他综合治疗,包括强心利尿、呼吸支持等.结果 PD治疗4h后,血清K+和HCO3-得到纠正,BUN、Scr下降,尿量增多.急性肾损伤4 h内开始PD患者治愈率85.29%,PD时间平均(25.05±16.36)h;4 h后PD患儿治愈率61.90%,PD时间平均(49.05±22.67)h.对比4 h内开始PD治疗较4 h后PD治疗患者恢复时间及死亡率比较差异有显著性(P＜0.05,0.01).结论婴幼儿先大性心脏病术后并发低心排、心力衰竭、急性肾功能不全时,尽早应用PD对改善患者预后有积极影响.
목적 탐토복막투석(PD)대영유인체외순배심장수술후적치료효과급기대술후조기혈류동역학적영향이급최가시궤.방법 회고분석2008년1월-2010년12월재아원행중증선천성심장병수술후영유인수요PD 55례환자,평균(1.6±0.8)세.응용외과수술치입복막투석관,동시여이기타종합치료,포괄강심이뇨、호흡지지등.결과 PD치료4h후,혈청K+화HCO3-득도규정,BUN、Scr하강,뇨량증다.급성신손상4 h내개시PD환자치유솔85.29%,PD시간평균(25.05±16.36)h;4 h후PD환인치유솔61.90%,PD시간평균(49.05±22.67)h.대비4 h내개시PD치료교4 h후PD치료환자회복시간급사망솔비교차이유현저성(P＜0.05,0.01).결론 영유인선대성심장병술후병발저심배、심력쇠갈、급성신공능불전시,진조응용PD대개선환자예후유적겁영향.
Objective To explore the efficacy of peritoneal dialysis(PD)for 55 infants and young children with acute kidney injury after cardiac surgery and to assess the effect of PD on hemodynamics and the optimal timing of PD.Methods The data on 55 infants and young children aged 9 days to 3 years [average(1.6 ±0.8) years] who had been hosptialized from January 2008 to December 2010 after cardiac surgery complicated with acute renal insufficiency were retrospectively analyzed.All the patients received peritoneal dialysis together with other comprehensive treatments including diuretics and respiratory support.Results After 4-hour dialysis,serum levels of K+and HCO3- were corrected and levels of BUN and Scr declined.The curative rate was 85.29%in those with therapy started within 4 hours of acute renal injury,and the average PD duration was(25.05±16.36)h,with a statistical significance(P＜0.05 and P＜0.01).as compared with a curative rate of 61.90%and average PD duration of(49.05±22.67)in those who received treatment 4 hours later.Conclusions As pediatric patients occurs low cardiac output,heart failure,and acute renal failure,early application of peritoneal dialysis is of active significance in improving prognosis.