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目的:探讨腹膜透析治疗小儿急性肾功能衰竭(ARF)的临床效果、安全性及并发症的防治等。方法:选择32例ARF患儿,年龄在1～12岁之间,平均6.1岁。行腹部手术,切开置入透析管,采用间歇腹膜透析(intermittent peritoneal dialysis IPD)及持续性非卧床腹膜透析(continuous ambulatory peritoneal dialysis,CAPD)进行腹膜透析。结果:腹透5天,血尿素氮(BUN)平均下降51.8%,血肌酐(Cr)平均下降43.3%,能有效维持水、电解质及酸碱平衡。住院期间,存活27例,死亡5例。腹透并发症发生率(人次)为31%,分别为腹膜炎4例,透析液渗漏重新置管2例,透析管堵塞4例。结论:腹膜透析治疗小儿急性肾功能衰竭的疗效肯定、安全,早期预防透析,积极预防和控制感染,可降低该病的病死率。
Objective: To investigate the clinical effect, safety and complications prevention and treatment of peritoneal dialysis in children with acute renal failure (ARF). Methods: 32 children with ARF were selected, aged from 1 to 12 years old, with an average of 6.1 years. Peritoneal dialysis was performed underwent abdominal surgery, incised into the dialysis tube, intermittent peritoneal dialysis (IPD) and continuous ambulatory peritoneal dialysis (CAPD). Results: After 5 days of peritoneal dialysis, blood urea nitrogen (BUN) decreased by 51.8% on average and serum creatinine (Cr) decreased by 43.3% on average, which effectively maintained water, electrolyte and acid-base balance. During hospitalization, 27 cases survived and 5 died. The incidence of peritoneal complications (person times) was 31%, which were 4 cases of peritonitis, dialysis fluid leakage re-catheterization in 2 cases, dialysis tube blockage in 4 cases. Conclusion: The peritoneal dialysis treatment of children with acute renal failure certainly positive, safe, early prevention dialysis, and actively prevent and control the infection, can reduce the case fatality rate.