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目的 观察持续性不卧床腹膜透析 (CAPD)对小儿急性肾功能衰竭 (ARF)的临床效果。方法 以Tenckhoff透析管 ,外科切开植入法 ,袋装腹膜透析液 ,应用CAPD法对小儿ARF进行腹膜透析 (PD)。结果 8例ARF患儿平均PD时间 (2 8 6 3± 2 0 0 3)天 ,院内期间存活 7例 ,死亡 1例。PD 1～ 3天血钾恢复正常 ,2～ 6天血HCO-3 恢复正常 ,5～ 7天血尿素氮、肌酐值分别下降 47 8%和 40 8% ,患儿尿毒症症状改善。并发症有腹透析液外渗 ,透析管引流不畅 ,腹膜炎等。结论 CAPD在救治小儿ARF中是一项安全、有效的肾脏替代疗法 ,能够有效控制患儿的各种代谢紊乱 ,改善尿毒症症状。
Objective To observe the clinical effect of continuous ambulatory peritoneal dialysis (CAPD) on children with acute renal failure (ARF). Methods Peritoneal dialysis (PD) was performed on pediatric ARF using the Tenckhoff dialysis tube, surgical incision implantation and bagged peritoneal dialysis solution. Results The mean PD time of 8 children with ARF was (286 ± 3) days, while that of survivors was 7 and the death was 1. The level of serum potassium returned to normal after 1 ~ 3 days of PD, and returned to normal after 2 ~ 6 days. Blood urea nitrogen and creatinine decreased by 47.8% and 40.8% respectively in 5-7 days. The symptoms of uremia in children were improved. Complications of dialysis fluid extravasation, dialysis tube drainage, peritonitis and so on. Conclusions CAPD is a safe and effective renal replacement therapy for pediatric ARF. It can effectively control various metabolic disorders in children and improve the symptoms of uremia.