小儿血液净化45例临床观察

目的 评价各种血液净化疗法对小儿急性肾功能衰竭(ARF)、慢性肾功能衰竭(cRF)、ARF并多器官功能障碍综合征(MODS)、药物毒物中毒的治疗效果。探讨血液透析(HD)、血液灌流(HP)过程中并发症的防治。方法应用日本东丽TR-321型血透机，NiproFB-70、90、110透析器对42例ARF、CRF患儿进行HD181次；连续性静-静脉血液滤过(CVVH)1例3次；应用TR-321血透机，爱尔(Aier)YTS-100血液灌流器对3例药物、毒物中毒进行HP6次。结合190次小儿血液净化中的操作特点，观察其治疗效果和并发症处理对策。结果42例ARF、CRF患儿经HD治疗后，尿毒症症状明显改善，氮质血症、高钾、低钠血症及严重代谢酸中毒予以纠正，尿毒症脑病得以清醒。3例药物、毒物中毒患儿经HP治愈。本组45例患儿治愈好转率91.1％，病死率2．2％。结论血液净化技术对小儿ARF、CRF和急性药物毒物中毒是最快速、有效的治疗方法。

Clinical observation on 45 child cases treated with blood purification

Objective To evaluate the therapeutic effect of each blood purification on children with acute renal failure (ARF), chronic renal failure(CRF), ARF with multiple organ dysfunction syndrome (MODS), drug and toxicant toxication, and to explore the prevention and cure of complications during the course of hemodialysis (HD) and hemoperfusion (HP). Methods Fourty-two children with ARF, CRF were treated with HD for 181 times with TR-321 and Nipro FB-70, 90, 110, one child was treated with continuous Venous-Venous Hemo filtration ( CVVH ) for 3 times, three children of drug and toxicant poisoning received HP for 6 times with TR-321 and YTS-100( Aier ). The operative characters of 190 times' blood purification were combined to observe the therapeutic effects and the policies for copying with complications. Results The uremic syndrome of forty-two children with ARF and CRF were improved obviously after every treatment of HD, azotemia hyperdalemia?hyponatremia and grave metabolic acidosis were corrected, children came back from uremic encephalophy . The response rates of 45 children were 91.1% , the mortality was 2.2%. Conclusion Blood purification technique was the most effective and fastest treatment in children with ARF, CRF and acute drug and toxicant toxication.