摘要
目的 分析连续不卧床腹膜透析 (CAPD)合并超滤衰竭 (Ultrafiltrationfailure ,UFF)的原因 ,并探讨其对策。方法 研究对象为 15例CAPD合并UFF的患者。记录UFF治疗前后每日腹膜透析次数、透析剂量、超滤量及尿量 ,腹膜平衡试验 (PET) ,测量血压 ,化验血肌酐、尿素氮及白蛋白。出现UFF时 ,化验腹水常规 ,腹水细菌培养 ,腹部B超。结果 CAPD合并UFF原因有 :①腹膜透析治疗依从性差 ;②患者饮食不当 ,特别是每日水盐摄入量过多 ;③残存肾功能逐渐减少 ;④原发病及其不可逆的病理生理改变 ;⑤腹膜炎 ;⑥腹膜超滤功能下降 ;⑦营养不良。UFF改善后 ,患者每日超滤量明显上升 (P <0 .0 1) ,血压平稳下降 (P <0 .0 1) ,血浆白蛋白明显回升 (P <0 .0 1)。结论 CAPD合并UFF的原因是多方面的 ,且UFF影响患者的预后。临床中应针对不同原因采取相应措施。
Objective To analyze the causes and find tactics in ambulatory continuous peritoneal dialysis with ultrafiltration failure. Methods Fifteen patients of ambulatory continuous peritoneal dialysis (CAPD) with ultrafiltration failure (UFF) were enrolled. Frequency and dosage of daily CAPD, ultrafiltration volume and urine volume were recorded. Peritoneal equilibrium test (PET) were performed. Blood pressure, serum creatinine, blood urea nitrogen and blood albumin were measured before and after treatment of UFF. When UFF occurred, routine analysis, bacteria culture of abdominal fluid and color Doppler were performed. Results The causes of UFF included: as follow ① The compliance of peritoneal dialysis prescription was poor; ② The diet of patients was not reasonable. Intake of water and salt was excessive especially; ③The function of remnant nephrons decreased progressively; ④ The irreversible pathologic physiologic course played a role in UFF; ⑤ Peritonitis was a common reason of UFF; ⑥ Peritoneal ultrafiltration function was reduced; ⑦ Malnutrition was indirect cause of UFF. The data showed that the increasing of filtration volume, decreasing of blood pressure, and increasing of serum albumin level occurred after amelioration of UFF (P < 0.01). Conclusions The causes of CAPD with UFF were multifarious. Ultrafiltration failure resulted in poor prognosis of patients with UFF. Various measures which aimed at various causes of UFF were performed. The effective therapy of UFF was prevention.
出处
《中国血液净化》
2004年第11期583-586,共4页
Chinese Journal of Blood Purification
关键词
腹膜透析
超滤衰竭
原因
分析
对策
Peritoneal dialysis
Ultrafiltration failure
Causes
Analysis
Tactics
