中国血液净化

中国血液净化 ›› 2019, Vol. 18 ›› Issue (06): 397-401.doi: 10.3969/j.issn.1671-4091.2019.06.006

• 临床研究 • 上一篇    下一篇

自动化腹膜透析在紧急起始的腹膜透析患者中的应用观察

杨刘阳1,杨芳1,裴华颖1   

  1. 1. 河北医科大学第二医院肾内科
  • 收稿日期:2018-09-05 修回日期:2019-03-19 出版日期:2019-06-12 发布日期:2019-06-12
  • 通讯作者: 裴华颖huayingpei@163.com E-mail:huayingpei@163.com

Application of automated peritoneal dialysis in patients with urgent-started peritoneal dialysis

  • Received:2018-09-05 Revised:2019-03-19 Online:2019-06-12 Published:2019-06-12

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摘要： 【摘要】目的观察自动化腹膜透析(automated peritoneal dialysis，APD)在紧急起始的腹膜透析患者的临床应用。方法选取河北医科大学第二医院54 例新置管的终末期肾衰竭患者，根据透析模式分为手工换液组(manual exchange peritoneal dialysis, MPD 组)和自动化腹膜透析组(APD 组)，分别观察1 周，并记录一般情况及生化指标、日平均透析量、超滤量、尿量、导管并发症等变化情况。结果透析治疗前2 组患者基线指标无显著差异。透析治疗1 周时APD 组和MPD 组2 组收缩压(t1=2.481, P1=0.023；t2=2.168, P2=0.038)、血尿素氮(t1=6.911, P1＜0.001；t2=7.661,P2＜0.001)、血肌酐(t1=3.191, P1=0.005；t2=3.363, P2=0.002)、血磷(t1=3.603,P1=0.002；t2=4.043,P2＜0.001) 较前下降，血红蛋白(t1=2.351, P1=0.030；t2=2.352, P2=0.025)、血钙(t1=3.008, P1=0.007; t2=2.933,P2=0.006)、血钠(t1=2.289,P1=0.034；t2=2.691,P2=0.011)较前升高。透析治疗期间，APD 组患者食欲改善较MPD 组改善明显(t=2.711,P=0.012)；在超滤量(t=4.067,P＜0.001)、尿量(t=2.173,P=0.035)、体质量(t=2.093,P=0.044)、血尿素氮(t=3.257,P=0.002)方面较MPD 组改善显著；2 组均无导管并发症发生。结论紧急起始行腹膜透析的终末期肾病患者使用APD清除毒素、改善症状效果好，患者耐受性好。

关键词: 腹膜透析, 自动化, 手工换液, 紧急起始, 终末期肾衰竭

Abstract: 【Abstract】Objective To observe the clinical application of automated peritoneal dialysis (APD) in urgent-started peritoneal dialysis patients. Methods We recruited 54 end-stage renal disease (ESRD) patients with newly placed peritoneal tubes and treated in the Second Affiliated Hospital of Hebei Medical University. They were divided into manual exchange peritoneal dialysis group (MPD group) and APD group. The general situation, biochemical indicators, average daily dialysis volume, ultrafiltration volume, urine output and catheter complications were recorded. They were observed for one week. Results ①There were no significant differences in baseline parameters between the two groups. ②For patients in the two groups after one week of the treatment, systolic blood pressure, blood urea nitrogen, serum creatinine and phosphorus were decreased (For APD group, t=2.481, 6.911, 3.191 and 3.603 respectively; P=0.023, ＜0.001, 0.005 and 0.002 respectively. For MPD group, t=2.168, 7.661, 3.363 and 4.043 respectively; P=0.038, ＜0.001, 0.002 and 0.000 respectively), and hemoglobin, serum calcium and sodium were increased (For PAD group, t=2.351, 3.008 and 2.289 respectively; P=0.030, 0.007 and 0.034 respectively. For MPD group, t=2.352, 2.933 and 2.691 respectively; P=0.025, 0.006 and 0.011 respectively) as compared to the baseline values. ③During the dialysis treatment, appetite improved more in APD group than in MPD group (t=2.711, P=0.012). ④There were no catheter complications in both groups. ⑤Ultrafiltration volume, urine volume, body mass and blood urea nitrogen improved more in APD group than in MPD group (t=4.067, 2.173, 2.093 and 3.257 respectively; P＜0.001, 0.035, 0.044 and 0.002 respectively). Conclusions In ESRD patients required urgent-started peritoneal dialysis, APD method had the advantages in toxin clearance, symptom improvement and compliance with the dialysis method.

Key words: Peritoneal dialysis, Automation, Manual exchange, Urgent-start, End-stage renal disease