中国实用儿科杂志

中国实用儿科杂志 ›› 2021, Vol. 36 ›› Issue (11): 869-873.DOI: 10.19538/j.ek2021110613

• 论著 • 上一篇    下一篇

腹膜透析治疗超低出生体重儿急性肾功能损伤的临床分析

  

  1. 北京大学第三医院儿科，北京  100191
  • 出版日期:2021-11-06 发布日期:2022-01-04
  • 通讯作者: 韩彤妍，电子信箱：tongyanhan@qq.com

Clinical analysis of peritoneal dialysis in the treatment of acute kidney injury in extremely low birth weight infants

  1. Department of Pediatrics，Peking University Third Hospital，Beijing  100191，China
  • Online:2021-11-06 Published:2022-01-04

摘要： 目的　总结腹膜透析（peritoneal dialysis，PD）治疗超低出生体重儿急性肾损伤（acute kidney injury，AKI）中存在的问题、原因及处理方法，以提高发生AKI的超低出生体重儿的救治能力。方法　回顾性分析北京大学第三医院新生儿重症监护病房2011年5月至2019年12月收治的7例经腹膜透析治疗AKI的超低出生体重儿的临床资料。 结果　7例PD治疗的AKI超低出生体重儿中，胎龄25～28周，出生体重（780～990）g；持续透析天数为2～18 d。3例出现置管处渗漏，2例发生腹膜炎。2例患儿治愈，3例生化指标好转，2例因高钾血症、心律失常死亡。7例患儿中5例透析前与透析后临床水肿、血肌酐、尿素氮、pH值、血钾均有好转。结论　腹膜透析是超低出生体重儿发生AKI时一种安全、有效、可行的治疗方法，等待患儿肾功能恢复，提高超低出生体重儿存活率。

关键词: 肾功能损伤, 腹膜透析, 超低出生体重儿

Abstract: Objective　To summarize the problems，causes and treatment of acute kidney injury（AKI） in extremely low birth weight infants（ELBWI） treated by peritoneal dialysis（PD），so as to improve the treatment ability of ELBWI with AKI. Methods　From May 2011 to December 2019，7 cases of ELBWI with acute kidney injury were treated by peritoneal dialysis in the Neonatal Intensive Care Unit（NICU），Peking University Third Hospital. The clinical data were analyzed retrospectively. Results　Among the 7 cases，the gestational age was（25-28）weeks，the birth weight was 780-990 g，and the duration of continuous dialysis was 2-18 d. There were 3 cases of catheter leakage and 2 cases of peritonitis. Two cases were cured，3 cases were improved，and 2 cases died of hyperkalemia and arrhythmia. The clinical complications of edema，increased serum creatinine，increased urea nitrogen，and potassium were improved in 5 cases after PD. Conclusion　Peritoneal dialysis is a safe，effective and feasible therapy for ELBWI with AKI，which increases the survival rate of ELBWI.

Key words: acute kidney injury, peritoneal dialysis, extremely low birth weight infants