CAPD术后两种即时透析方式的疗效观察.pdfVIP

西部医学2008年3月第2O卷第2期 Med J West China，March 2008，Vo1．20，No．2 265 CAPD术后两种即时透析方式的疗效观察 崔天蕾，村 平，钟 慧 ，沙朝晖，唐晓红 (四川大学华西医院肾内科，四川 成都 610041) 【摘要】 目的 探讨CAPD术后即时透析的最佳方式。方法 选择行首次腹透植管术的慢性肾衰竭尿毒症患者 146例，于CAPD术后随机分为强化透析组7O例和减半透析组76例，强化透析组术后第1～3 d行1000ml腹透，每日10 次；减半透析组第1～3 d每日1000ml腹膜透析6次。分别观察两组惠者CAPD术后即时透析疗效及并发症情况，并进 行比较。结果 两组病人透析前后血BUN、Cr、Hb、Alb、电解质等比较无差异(P0．05)；但2周内并发症比较差异有显 著性(PO．05)，强化透析组共发生不良反应36例次，发生低血钾和低血压分剐为19和8例次；减半透析组共发生不良 反应14例次，仍以低血钾、低血压常见。所有的不良反应均经对症支持治疗后好转，未停止腹透，术后2周内均未发生腹 膜感染。结论 CAPD术后即时行腹膜透析切实可行，减半透析方式优于强化透析方式。 【关键词】 腹膜透析；尿毒症； 并发症 【中图分类号】 R459．5 【文献标识码】 A 【文章编号】 1672—3511(2008)02—0265—03 Efficacy of two dialysis modalities immediate after CAPD catheter insertion CUI Tian-lei，FU Ping，ZHONG Hui，et al (Nephrology of Sichuan University West China Hospital，Chengdu 610041，China) [Abstract] Objective To investigate the efficacy of different dialysis modalities immediate after CAPD catheter insertion by comparing effectiveness and short-term complications．Methods 146 chronic uremic patients who received the first CAPD catheter insertion in our hospital from January 2004 to December 2005 were enrolled in this study．The average age was 43士1 3 years(20—74 years)including 89 male and 57 female patients．Patients after CAPD insertion were randomized assigned to the intensive dialysis group(70 patients with an average age 44士1 1 years)and the controlled group(76 patients with an average age 43士14 years)．From the first day after CAPD insertion tO the third day，patients in intensive dialysis group underwent peritoneal dialysis with 1000ml／exchange，10 exchanges／day，while in the controlled group patients underwent peritoneal dialysis with 1000ml／exchange，6 exchanges／day．Co