尿病肾病并难治性心衰非尿毒症的腹膜透析治疗

目的:糖尿病肾病非尿毒症者合并难治性心衰并不少见,本文介绍了2例患者经腹膜透析治疗始末,并进行相关文献复习.方法:对2例糖尿病肾病非尿毒症合并难治性心衰的患者行腹膜透析,记录透析前后出入量、体重、水肿程度、心功能和血压变化,以及药物种类和剂量、住院费用和时间,透析并发症等,并随访至出院后2月.结果:2例患者行腹膜透析后,出入量明显负平衡,2～3周后体重下降达20%、全身水肿消退,心功能明显改善,血压易于控制,利尿剂抵抗得以改善.同时,腹膜透析后用于心衰治疗的药物种类减少,住院天数和费用下降,除漏液外未发生任何并发症.2例患者在随访2月中保持容量稳态.结论:对于糖尿病肾病非尿毒症者合并难治性心衰的治疗,腹膜透析不但具有简单、有效、安全和经济的优点,还具有长期效应.

Two Patients with Non-uremia Diabetic Nephropathy and Peritoneal Dialysis and Literatre Reviews

Objective:It is often seen that refractory heart failure exists in patients with non-uremia diabetic nephropathy.We introduced two such patients who treated with peritoneal dialysis (PD) and further reviewed related literatures.Methods:We recorded the information of two patients fore-and -aft PD,included that in and out volumes,body weights,edema degree,heart function and blood pressures.The sorts and dosages of drugs,expenses and time in hospital,side effects of PD were all investigated.Results:Two patients were in negative balance of in-out volume after PD,and body weights decreased 20% in two to three weeks.Moreover,heart function was improved,blood pressures easily controlled, diuretic drugs resistance ameliorated.In the same time,the sorts and dosages of drugs reduced,did expenses and time in hospital too.Steady volume balances were found in these two patients in two months follow-up.Conclusion:Peritoneal dialysis is not only a simple,effective,safe and economic treatment,but also has long effect in non-uremia diabetic nephropathy patients with refractory heart failure.