CAJ | 학술논문

目的探讨急性间歇性腹膜透析(AIPD)对急性肾损伤并多器官功能障碍婴幼儿的有效性及安全性.方法选取2006年9月至2014年5月于贵州省人民医院各重症监护室住院治疗的多器官功能障碍并急性肾损伤的婴幼儿患者26例,年龄2个月至3岁.分为对照组(n=14)及AIPD组(n=12),回顾性分析血肌酐(Scr)、尿素氮(BUN)、二氧化碳结合力(CO2CP)、血钾(K+)及C反应蛋白(CRP)的变化,以及患儿的肾功能恢复率与30 d病死率.结果 AIPD组Scr、BUN较治疗前显著下降(P＜0.05),与对照组相比,亦显著降低(P＜0.05);血K+较治疗前明显下降(P＜0.05),CO2CP较治疗前明显升高(P＜0.05);CRP较治疗前有下降趋势,但差异无统计学意义,亦低于对照组,差异亦无统计学意义.AIPD组患儿充血性心衰及肺水肿等病情改善更为明显,其肾功能恢复率达41.67％,显著高于对照组(14.29％)(P=0.003);脱离呼吸机比率较对照组显著提高(58.33％比28.57％,P=0.086);30 d病死率亦显著低于对照组(15.4％比36.9％,x2=9.58,P=0.020).结论 AIPD能有效清除MODS并急性肾损伤婴幼儿体内多余水分、毒素,纠正电解质及酸碱平衡紊乱,增加肾功能恢复率,减少病死率,是MODS并AKI低龄患儿有效的肾替代治疗方式.
목적 탐토급성간헐성복막투석(AIPD)대급성신손상병다기관공능장애영유인적유효성급안전성.방법 선취2006년9월지2014년5월우귀주성인민의원각중증감호실주원치료적다기관공능장애병급성신손상적영유인환자26례,년령2개월지3세.분위대조조(n=14)급AIPD조(n=12),회고성분석혈기항(Scr)、뇨소담(BUN)、이양화탄결합력(CO2CP)、혈갑(K+)급C반응단백(CRP)적변화,이급환인적신공능회복솔여30 d병사솔.결과 AIPD조Scr、BUN교치료전현저하강(P＜0.05),여대조조상비,역현저강저(P＜0.05);혈K+교치료전명현하강(P＜0.05),CO2CP교치료전명현승고(P＜0.05);CRP교치료전유하강추세,단차이무통계학의의,역저우대조조,차이역무통계학의의.AIPD조환인충혈성심쇠급폐수종등병정개선경위명현,기신공능회복솔체41.67％,현저고우대조조(14.29％)(P=0.003);탈리호흡궤비솔교대조조현저제고(58.33％비28.57％,P=0.086);30 d병사솔역현저저우대조조(15.4％비36.9％,x2=9.58,P=0.020).결론 AIPD능유효청제MODS병급성신손상영유인체내다여수분、독소,규정전해질급산감평형문란,증가신공능회복솔,감소병사솔,시MODS병AKI저령환인유효적신체대치료방식.
Objectives To investigate the effect of acute intermittent peritoneal dialysis (AIPD) in multiple organ dysfunction syndrome (MODS) infants with acute kidney injury (AKI) and to assess the effectiveness of the treatment.Methods Twenty-six cases of MODS infants with AKI (Age for 2 months to 3 years) treated with AIPD (AIPD group,n=12) or not (Control group,n=14) in intensive care unit of People' s Hospital of Guizhou Province from September 2006 to May 2014 were retrospectively reviewed.Clinical characteristics including Scr,BUN,CO2CP,serum K+ and C reactive protein (CRP) before and after dialysis,mortality and renal recovery rate within 30 days were analyzed and compared between the two groups.Result After AIPD,the levels of Scr and BUN decreased significantly (P ＜ 0.05),and comparison with control group was the same; serum K+ declined and CO2CP increased obviously (P＜0.05); CRP also decreased but without significant difference as well as comparison with control group.Compared with control group,these infants in AIPD group showed more significant improvement,including congestive heart failure and pneumonedema; both of renal recovery rate(41.67％ vs 14.29％,P=0.003) and ventilator weaning rate (58.33％ vs 28.57％,P=0.086) remarkablely raised respectively; mortality rate within 30 days significantly reduced (15.4％ vs 36.9％,x2=9.58,P=0.020).Conclusion AIPD is a kind of effective way of renal replacement therapy,which can effectively clean out superfluous water and toxin,as well correct electrolyte imbalance,enhance renal recovery rate and reduce mortality rate,and is effective to MODS infants with AKI.