容量控制对腹膜透析患者体液平衡的影响

目的探讨容量负荷控制对持续性腹膜透析(CAPD)患者体液平衡的影响。方法选择山东中医药大学第二附属医院肾内科CAPD治疗患者32例,限制水盐摄入1-3个月,测定限制水盐前后体重、平均动脉压、超滤量、下腔静脉直径(IVCD)等相关指标。结果CAPD患者限制水盐后水肿程度、体重、平均动脉压、透析液糖浓度、透析液糖总量、透析液总剂量、每日平均超滤量及总液体清除量与限制水盐以前比较明显降低,P<0．05差异有显著性。IVCD与收缩压值有直线相关关系(r前=0．407,P<0．01;r后=0．413,P<0．01)。限制水盐前后患者的尿量无明显变化,P>0．05。结论严格限制腹膜透析患者水钠摄入,可降低容量负荷,从而降低血压、减轻水肿,改善患者的一般状况;下腔静脉直径能精确评估体液负荷状况。

Effect of controlling fluid on body fluid balance in continuous ambulatory peritoneal dialysis patients

Objective To study the effect of controlling fluid ingestion on body fluid bolance in continuous ambulatory peritoneal dialysis (CARD) patients. Methods Thirty-two CAPD patients were selected, and their salt and water ingestion were restricted for 1-3 months. The weight, mean arterial pressure, peritoneal ultrafiltration and the inferior vena cava diameter (IVCD) of these patients were followed up. Results After restricting salt and water, edema, body weight, mean arterial pressure, dialysate doses, dialysate glucose load, peritoneal ultrafiltration and total fluid removal were significantly decreased(P <0. 05), whereas the urine volume did not change significantly (P>0. 05). IVCD and systolic pressure had linear correlation in CAPD patients. Conclusions Restricting salt and water intake may reduce the fluid overload, so edema and blood pressure can be relieved and general condition can be improved in CAPD patients. The IVCD can be used to evaluate fluid status of patients preciseby.