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目的研究腹膜透析对治疗多脏器功能衰竭并急性肾损伤(AKI)患者的效果。方法回顾分析采用持续性非卧床腹膜透析法治疗的30例多脏器功能衰竭并急性肾损伤患者的临床资料,对比治疗前后患者血压、尿量及血液中K~+、HCO_3~-、尿素氮、血肌酐等临床及生化指标变化,分析腹膜透析治疗AKI的安全性及有效性。结果治疗前,患者尿素氮水平为(40.35±14.98)mmol/L,血肌酐水平为(1005.23±150.67)μmol/L,尿量为(231.58±55.80)ml/24 h;治疗后,患者尿素氮水平为(21.03±9.65)mmol/L,血肌酐水平为(435.23±65.31)μmol/L,尿量为(593.60±151.28)ml/24 h。治疗前后尿素氮、血肌酐水平及尿量水平比较差异具有统计学意义(P<0.01)。治疗前,患者K~+水平为(7.01±0.90)mmol/L,HCO_3~-水平为(10.15±2.45)mmol/L,Na~+水平为(131.59±6.39)mmol/L,Ca~(2+)水平为(1.91±0.38)mmol/L,P水平为(1.53±0.64)mmol/L,治疗后,患者K~+水平为(4.43±0.90)mmol/L,HCO_3~-水平为(19.31±3.45)mmol/L,Na~+水平为(140.76±5.68)mmol/L,Ca~(2+)水平为(2.11±0.23)mmol/L,P水平为(1.15±0.31)mmol/L,治疗前后患者K~+、HCO_3~-、Na~+、Ca~(2+)、P水平比较差异具有统计学意义(P<0.01)。30例患者中无腹膜感染发生,存活率为90%。结论腹膜透析对多脏器功能衰竭并急性肾损伤具有满意的疗效,可在临床应用。
Objective To study the effect of peritoneal dialysis on patients with multiple organ failure and acute kidney injury (AKI). Methods The clinical data of 30 patients with multiple organ failure and acute kidney injury treated with continuous ambulatory peritoneal dialysis were retrospectively analyzed. The changes of blood pressure and urine volume and blood K +, HCO 3 -, urea nitrogen , Serum creatinine and other clinical and biochemical changes in the analysis of peritoneal dialysis AKI safety and effectiveness. Results Before treatment, the level of urea nitrogen was (40.35 ± 14.98) mmol / L, the level of serum creatinine was (1005.23 ± 150.67) μmol / L and the volume of urine was (231.58 ± 55.80) ml / 24 h. The level of serum creatinine was (21.03 ± 9.65) mmol / L, serum creatinine level was (435.23 ± 65.31) μmol / L and urine output was (593.60 ± 151.28) ml / 24 h. Before and after treatment of urea nitrogen, serum creatinine and urine levels were significantly different (P <0.01). The level of K ~ + was (7.01 ± 0.90) mmol / L, the level of HCO_3 ~ (10.15 ± 2.45) mmol / L and the level of Na ~ + were 131.59 ± 6.39 mmol / L and Ca ~ The level of K + was (4.43 ± 0.90) mmol / L and the level of HCO 3 - was (19.31 ± 0.38) mmol / L and (1.53 ± 0.64) mmol / ± 3.45 mmol / L, the level of Na ~ + was (140.76 ± 5.68) mmol / L, the level of Ca 2+ was (2.11 ± 0.23) mmol / L and the level of P was (1.15 ± 0.31) mmol / The levels of K ~ +, HCO 3 ~ -, Na ~ +, Ca ~ (2 +) and P in patients before and after treatment were significantly different (P <0.01). 30 patients without peritoneal infection, the survival rate was 90%. Conclusion Peritoneal dialysis has satisfactory curative effect on multiple organ failure and acute renal injury, which may be used in clinical practice.