CAJ | 학술논문

目的：探讨腹膜透析治疗儿童先天性心脏病术后急性肾功能不全的疗效及对血清学指标的影响。 　　方法：收集2011-12至2014-12在我院行体外循环心内直视下先天性心脏病矫治术的患儿48例作为研究对象，按照随机数表法将所有入组患儿分为观察组（24例，接受腹膜透析治疗）和对照组（24例，接受常规治疗），比较两组患儿在治疗前、治疗后的肾功能指标、血电解质水平、炎症因子水平等差异。 　　结果：观察组患儿接受治疗后的血肌酐、尿素氮、尿β2微球蛋白及24 h尿蛋白水平明显低于对照组（P<0.05）；血K+水平明显低于对照组，Ca2+、HCO-3水平明显高于对照组（P<0.05）；超敏C反应蛋白、肿瘤坏死因子-α、白细胞介素-6水平明显低于对照组（P<0.05），差异均有统计学意义。观察组患儿治愈率和死亡率均优于对照组（P<0.05），未发现与腹膜透析相关的远期并发症。 　　结论：腹膜透析可以有效改善先天性心脏病术后急性肾功能不全患儿的肾功能，优化血电解质及炎症因子水平。
목적：탐토복막투석치료인동선천성심장병술후급성신공능불전적료효급대혈청학지표적영향。 　　방법：수집2011-12지2014-12재아원행체외순배심내직시하선천성심장병교치술적환인48례작위연구대상，안조수궤수표법장소유입조환인분위관찰조（24례，접수복막투석치료）화대조조（24례，접수상규치료），비교량조환인재치료전、치료후적신공능지표、혈전해질수평、염증인자수평등차이。 　　결과：관찰조환인접수치료후적혈기항、뇨소담、뇨β2미구단백급24 h뇨단백수평명현저우대조조（P<0.05）；혈K+수평명현저우대조조，Ca2+、HCO-3수평명현고우대조조（P<0.05）；초민C반응단백、종류배사인자-α、백세포개소-6수평명현저우대조조（P<0.05），차이균유통계학의의。관찰조환인치유솔화사망솔균우우대조조（P<0.05），미발현여복막투석상관적원기병발증。 　　결론：복막투석가이유효개선선천성심장병술후급성신공능불전환인적신공능，우화혈전해질급염증인자수평。
Objective: To explore the effects of peritoneal dialysis on acute renal insufifciency and on relevant blood indicators in children with congenital heart disease (CHD) after the operation. Methods: A total of 48 CHD patients received direct open heart surgery by cardiopulmonary bypass and suffered from post-operative acute renal insufifciency in our hospital from 2011-12 to 2014-12 were retrospectively analyzed. The patients were divided into 2 groups: Peritoneal dialysis group and Routine medication group,n=24 in each group. The differences of renal function indexes, the blood levels of electrolyte and inlfammatory factors were compared between 2 groups. Results: Compared with Routine medication group, the patients in Peritoneal dialysis group presented decreased serum critinine, BUN and urine β2-micro globulin, 24-hour protein level,P<0.05; decreased blood K+ level and increased blood levels of Ca2+, HCO-3P<0.05; decreased plasma levels of hs-CRP, TNF-α, IL-6,P<0.05. The cure rate and mortality in Peritoneal dialysis group were better than those in Control group,P<0.05. No long term complication related to peritoneal dialysis was found. Conclusion: Peritoneal dialysis may improve the renal function in CHD patients with post-operative acute renal insufifciency and optimize the blood levels of electrolyte and inlfammatory factors.