中国血液净化

中国血液净化 ›› 2015, Vol. 14 ›› Issue (02): 89-92.doi: 10.3969/j.issn.1671-4091.2015.02.00

• 临床研究 • 上一篇    下一篇

腹膜透析结合血液透析治疗终末期肾病 3例长期疗效并文献复习

韩天瞾,,龚蓉,皮婧静,舒英,梁柱,佘宁兰,李迎春,范妙仪   

  1. 重庆医科大学附属成都第二临床学院 成都市三人民医院肾脏科
  • 收稿日期:2014-06-13 修回日期:2014-10-11 出版日期:2015-02-12 发布日期:2015-02-12
  • 通讯作者: 龚蓉 gongr2006@sina.com E-mail:hildahan1985@sina.com

Long-term clinical effects of combined therapy with peritoneal dialysis and hemodialysis: report of 3 cases and review of the literature

  • Received:2014-06-13 Revised:2014-10-11 Online:2015-02-12 Published:2015-02-12

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摘要： 【摘要】目的 探讨腹膜透析结合血液透析(Combined therapy with Peritoneal Dialysis and Hemodialysis PHD)治疗终末期肾病(End stage renal disease ESRD)患者的长期临床疗效。 方法 对3例长期行PHD治疗的患者临床资料进行分析并复习相关文献。 结果 3例患者经过PHD治疗后临床症状改善。例1 周尿素清除指数(Kt/V/W) 1.46增至1.90，周肌酐清除率(Weekly creatinine clearance WCC)36.52增至60.72L/1.73m2，血浆白蛋白、血红蛋白升高，左室肥厚(Left ventricle hypertrophy LVH)改善。例2 Kt/V/W 1.43增至1.81， WCC 35.34增至55.79 L/1.73m2，血浆白蛋白、血红蛋白升高。例3 Kt/V/W 1.55增至1.82，WCC 46.0增至56.53 L/1.73m2，血浆白蛋白、血红蛋白升高，LVH改善。 结论 PHD能有效改善ESRD患者临床症状，提高透析充分性，可作为补充的肾脏替代治疗模式在临床应用。

关键词: 终末期肾病, 腹膜透析结合血液透析, 长期疗效

Abstract: 【Abstract】 Objective To evaluate the long-term clinical effect of combined therapy with peritoneal dialysis and hemodialysis (PHD) in the treatment of patients with end-stage renal disease (ESRD). Methods We summarized the effect of PHD in 3 ESRD cases and reviewed the related literature. Results The 3 male ESRD cases were 34-54 years old, and were undergone PHD for 1-4 years. The primary disease was chronic glomerulonephritis in 2 cases, diabetic nephropathy in one case. After PHD treatment, clinical status improved. In case 1, weekly urea Kt/V increased from 1.46 to 1.90, weekly creatinine clearance (WCC) from 36.52 to 60.72 L/1.73 m2, plasma albumin from 3.30 mg/dl to 3.60 mg/dl, and hemoglobin from 8.1 g/dl to 11.0 g/dl. Echocardiography showed the improvement of left ventricular hypertrophy. In case 2, weekly urea Kt/V increased from 1.43 to 1.81, WCC from 35.34 to 55.79 L/1.73 m2, plasma albumin from 3.50 mg/dl to 3.92 mg/dl, and hemoglobin from 9.6 g/dl to 11.6 g/dl. In case 3, weekly urea Kt/V increased from 1.55 to 1.82, WCC from 46.0 to 56.53 L/1.73 m2, plasma albumin from 3.50 mg/dl to 4.02 mg/dl, and hemoglobin from 7.8 g/dl to 9.2 g/dl. Echocardiography showed the improvement of left ventricular hypertrophy. Conclusion PHD can effectively improve the clinical symptoms and dialysis adequacy in ESRD patients. It may be used as a supplementary alternative of renal replacement therapy in clinical practice.

Key words: End-stage renal disease, combined therapy with Peritoneal Dialysis and Hemodialysis, long-term clinical effect