狼疮性肾炎合并急性肾功能衰竭25例临床分析

目的探讨25例狼疮性。肾炎合并急性肾功能衰竭的临床特点。方法回顾性分析2000年1月～2010年12月于我院就诊治疗的25例狼疮性肾炎合并急性肾功能衰竭患者的临床资料,分析治疗和预后特点。结果治疗后患者的生存率为80％,病死率为20％。生存组患者的尿蛋白定量、可溶性补体受体（human soluble complement receptor,SCR）含量显著低于死亡组患者,CCR趋化因子受体（chemokine CCR receptor,CCR）、C3补体的含量显著高于死亡组患者。狼疮性肾炎合并其他受损的器官数目越多,患者的病死率越高。结论狼疮性肾炎合并急性肾功能衰竭和多器官功能损害者的预后较差,病死率较高。     

腹膜透析抢救急性肾功能衰竭16例

目的:分析总结腹膜透析治疗急性肾功能衰竭(ARF)的疗效,方法:对16例ARF患者进行腹膜透析,采用Baxter标准透析液和Tenckhoff单cuff直管,抵达膀胱直肠窝内,进行腹膜透析,结果:14例治愈,治愈率(87.4%),结论:腹膜透析治疗ARF疗效可靠,早期透析可减少死亡率,腹膜透析设备简单,不改变血液动力学,心血管稳定性好,特别适用于基层以及儿童患者血管通路难建立及心脑血管功能不稳定的老年患者.     

腹膜透析治疗急性肾功能衰竭52例

目的为进一步探讨腹膜透析(PD)在急性肾功能衰竭(ARF)患者中的治疗作用.方法采用PD技术治疗ARF 52例,其中并发急性肺水肿29例(55.8%)、高钾血症32例(61.5%)、昏迷16例(30.7%)、多脏器功能衰竭(MOF)6例(11.5%)、高分解ARF 3例.结果46例患者肾功能恢复正常(88.5%).结论PD不需要特殊设备,技术简单,安全可靠,不仅适用于无并发症的ARF患者,而且也适用于并发急性肺水肿、高钾血症、脑水肿、MOF、高分解型ARF及幼儿患者.     

腹膜透析治疗儿童急性肾功能衰竭体会

急性肾功能衰竭（ARF）严重威胁儿童的生命。近年来,我们用腹膜透析（PD）方法治疗儿童急性肾功能衰竭13例,取得了良好疗效,现报道如下。l临床资料1．l一般资料1993年一1998年,我科为13例急性肾功能衰竭患儿进行了腹膜透析治疗。其中男性9例,女性4例。年龄最大13岁,最小6岁,平均（8．522．阿岁。原发疾病为：毒章中毒5例;鱼苦胆中毒4例;急进性肾小球肾炎1例;肾病综合症1例;氨基糖式类抗菌素肾损1例;败血症1例。l．2临床表现13例患儿均为少尿型ARF,其中少尿3例,无尿Ic例;合并心衰,急性肺水肿9例（69．2％）;高血压6例（…     

腹膜透析抢救小儿急性肾功能衰竭

小儿急性肾功能衰竭 (Ａｃｕｔｅｒｅｎａｌｆａｉｌｕｒｅ ,ＡＲＦ)是临床上非常多见的小儿急症 ,病死率高。本院于1995年开展了小儿ＡＲＦ急诊腹膜透析 ,生存率较前有显著提高 ,现报告如下。1　对象和方法1 1　研究对象　本组患儿共 10例 ,其中男 7例 ,女3例 ,年龄 3～ 11岁。急性肾小球肾炎 6例 ,氨基糖甙类抗生素中毒 2例 ,磺胺类致肾脏结晶 1例 ,鱼胆中毒 1例。均符合ＡＲＦ诊断标准[1] 。1 2　方法　本组患儿均在局麻下行腹透置管术 ,采用Ｂｒａｕｎ的急性腹透管 ,旁正中切口 ,置管成功后即可行腹透治疗。采用Ｂａｘｔｅｒ的腹膜透析…     

腹膜透析治疗急性肾功能衰竭6例

目的 探讨腹膜透析治疗急性肾功能衰竭的疗效. 方法 使用腹膜透析治疗急性肾功能衰竭患者6例. 结果 6例患者全部治愈,康复出院. 结论 腹膜透析治疗急性肾功能衰竭不需要特殊设备,技术简单,疗效可靠,特别适合心血管条件差的老人和幼儿患者.     

狼疮性肾炎并急性肾功能衰竭45例临床研究

目的探讨狼疮性肾炎合并急性肾功能衰竭的临床特点。方法回顾性分析2002年1月～2010年12月于我院就诊治疗的45例狼疮性肾炎合并急性肾功能衰竭患者的临床资料,分析治疗特点和预后特点。结果治疗后患者的生存率为80．0％（36／45）．死亡率为20．0％（9／45）。生存组患者的尿蛋白定量、SCr含量显著低于死亡组患者,CCr、C3的含量显著高于死亡组患者。狼疮性肾炎合并其他受损的器官数目越多,患者的死亡率越高。结论狼疮性肾炎合并急性肾功能衰竭的预后较差,死亡率较高,尤其是合并多器官损害者。     

Application of peritoneal dialysis for the treatment of acute renal failure in children underwent cardiac surgery

Objective The aim of this study is to evaluate the efficiency of peritoneal dialysis（PD） for the treatment of acute renal failure（ARF）in children following open-heart surgery. Methods The clinical records of 63 consecutive eases [ mean age（3.60 ± 3.67） years, mean weight（ 13.45 ± 7.68）kg],of ARF after cardiac surgery for congenital heart defects between October 1999 and October 2005 were reviewed. Indications for PD included oliguria for more than 4 hours despite medication interventions or, in the absence of established ohguria, increased creatinine level in association with one of the followings, clinical signs of fluid overload, hyperkalemia （ 〉 5.5 mmoI/L）, persistent metabolic acidosis, or low cardiac output syndrome. Following data were collected in all patients： time to initiation and duration of PD; time point of the recovery of urine output; baseline serum creatinine level （Cr0）, rise of Cr（Cr1 ）, peak Cr （Cr2）, descending Cr （Cr3）, recovery of Cr （ Cr4 ） ; and their corresponding postoperative time points. Results Of the 63 patients, 58 （92.1% ） required PD. Overall mortality rate was 33.3% （21/63）. Patients undergone more complex surgery requiring longer aortic clamping time;have higher Cr0, Cr2, Cr3 and longer period of the recovery of Cr and urine output（P〈0.05,P〈 0.01） more likely required PD. Prolonged PD （ PD 〉 6d） was associated with more complicated surgical procedure, higher Cr1 and Cr2, delayed recovery of Cr and urine output after surgery, longer period of low cardiac output syndrome, more dysfunctional organs, longer mechanical ventilation and ICU stay postoperatively （ P 〈 0.05, P 〈 0.01）. Peritoneal dialysis was proved effective and safe in improving renal function m all survivors. Conclusion Risk factors for PD in children undergoing open heart surgery are complex operation, longer aortic clamping duration, and more severs ARF with delayed recovery of serum creatinine level and urine output. The postoperative hemo     

腹膜透析在心脏直视术后急性肾功能衰竭的应用

目的 总结心脏直视手术后急性肾功能衰竭应用腹膜透析治疗的经验。方法 9例患者因心脏术后急性肾功能衰竭接受腹膜透析治疗，应用外科手术置入腹膜透析管，进行透析治疗，同时进行常规的综合治疗，包括强心、利尿、呼吸机支持。结果 治愈6例，死亡3例，1例因腹膜透析不及时(于低心排综合症发生后24小时透析)，行腹膜透析后8小时因多器官功能衰竭死亡，1例因术后严重肺循环高压死亡，1例术后13天(急性肾功能衰竭已治愈)因纵隔感染死亡。治愈组透析25～97小时，血生化恢复正常，肾脏功能及血流动力学明显改善。全组无严重腹腔感染、高血糖、低血钾等并发症。结论 心脏直视手术后急性肾功能衰竭患者及时应用腹膜透析治疗，是一种安全、有效的治疗措施，对病人预后有积极的影响。     

Intermittent peritoneal dialysis in the treatment of end-stage renal failure.

Our experience of 54 patients with end-stage renal failure, who were treated with intermittent peritoneal dialysis and compared with patients maintained by haemodialysis over the years 1972 to 1978, has been reviewed. All patients received peritoneal dialysis for more than six weeks. The total experience was 32.8 patient dialysis-years, 48% as home dialysis. Peritoneal dialysis was used as an interim procedure in 19 patients who were waiting for haemodialysis. However, in 35 patients (particularly in the very young and elderly, and in situations of poor social support), recurrent peritoneal dialysis was chosen as the definitive dialysis therapy. Dialysis was assessed as "adequate" in all, but two, patients. The major complication of peritoneal dialysis was peritonitis, although its over-all incidence of 1.31 episodes per patient dialysis-year was low. An attack of peritonitis occurred every nine months of patient exposure, though the incidence of bacterial peritonitis averaged only once every 26 months. Fifty per cent of patients never had an episode of peritonitis. Intermittent peritoneal dialysis was associated with greater morbidity and mortality than haemodialysis, perhaps due, in part, to the older age of the peritoneal dialysis group. Intermittent peritoneal dialysis is a valuable adjunct to haemodialysis and transplantation in the treatment of end-stage renal failure.     

多器官功能衰竭中急性肾衰的腹透治疗

对１５例不适合作血透治疗的多脏器功能衰竭中的急性肾功能衰竭患者，于确立诊断后２４ｈ内立即行间歇性腹膜透析治疗。除３例因呼吸循环衰竭死亡外，１２例患者于半月内肾功能恢复或基本恢复。认为对不适合血液透析的多脏器衰竭中的急性肾功能衰竭患者，腹膜透析具有较好的效果。