腹膜透析并发症临床分析

目的　分析腹膜透析 (PD)患者并发症的临床特点及其相关因素。方法　调查 12例腹膜透析患者并发症的发生率 ,并与 32例血液透析 (HD)患者并发症进行比较。检测每位腹膜透析患者血肌酐 (Scr)、尿素氮 (BUN)、血浆白蛋白 (Alb)、前白蛋白 (PA)、血红蛋白 (Hb)、甲状旁腺激素 (PTH)及胆固醇 (TCH) ,测量血压 ,做心电图和心脏超声 ,评价心功能。结果　两种透析方式并发症的发生率相当 ,且心力衰竭、高血压、感染和营养不良为其主要并发症。在腹膜透析患者中 ,心力衰竭组和感染组的血浆白蛋白、前白蛋白、胆固醇及血红蛋白分别明显低于非心力衰竭组和非感染组 (P <0 .0 1) ,心力衰竭组和感染组普遍存在血压偏高 ,心脏增大 ,心肌缺血 ,和射血功能减低 (P <0 .0 1)。结论　心血管疾病、感染和营养不良是腹膜透析患者常见并发症 ,是导致死亡和预后不良的主要原因 ,与血液透析并发症类似。

Analysis of complications in peritoneal dialysis patients

Objective To analyze the complications and relative causes in peritoneal dialysis (PD) patients. Methods Twelve PD patients were enrolled. Occurrence rate of complications were investigated and compared with the complications in 32 hemodialysis (HD) patients. Blood creatinine, blood urine nitrogen, blood albumin, pre_albumin, hemoglobin, parathormone and cholesterol of PD patients were tested. Blood pressure, electrocardiogram (ECG) and ultrasonic cardiogram (UCG) were measured and cardiac functions were evaluated in PD patients. Results Complications of two dialysis methods were the same. The main complications were heart failure, hypertension, infection and malnutrition. In PD patients, blood albumin, pre_albumin, cholesterol and hemoglobin of heart failure group and infection group were lower than that of non_heart failure group and non_infection group, respectively (P<0.01). Hypertension, cardiac enlargement, myocardial ischemia and lower ejective fraction were common in heart failure group and infection group of PD patients (P<0.01). Conclusions Cardiac_vascular disease, infection and malnutrition were the main complications and the main causes which resulted in death and poor prognosis in PD patients. Those were similar to the complications in hemodialysis patients.