摘要
目的设计一种可连续多次测量腹腔内压力(腹内压)的装置,并评估该装置在腹膜透析(腹透)患儿中临床应用的可行性和安全性。方法设计的腹内压测量装置采用三通装置连接腹透外接管、带刻度的玻璃管及双联腹透液袋,通过转动三通装置实现腹透液的定量注入和腹内压的测量。测量在平静呼吸状态下进行,测量不同灌入量下的腹内压。研究对象来自2019年5月至2020年2月在复旦大学附属儿科医院接受腹透治疗且透析龄>1个月的患儿,收集入选者人口学及临床资料。记录测量过程患儿的主诉、体征、有无腹透导管污染、腹内压测量后压力相关并发症及感染情况,随访腹透患儿腹内压测量后3个月的结局。采用散点图和Pearson相关分析法分析灌注量与腹内压的相关性。结果9例接受自动化腹透治疗的患儿入选本研究,年龄(8.4±4.7)岁,体表面积(0.84±0.29)m^(2)。9例患儿灌注量为1000 ml/m^(2)时的腹内压为(12.6±1.9)cmH2O(1 cmH2O=0.098 kPa),灌注量1200 ml/m^(2)时的腹内压为(13.8±1.9)cmH2O。测量装置安全可行,测量过程中未发生过导管污染,住院期间所有患儿未发生腹膜炎。随访3个月,除1例患儿因脐疝转血液透析外,其余患儿未出现压力相关并发症。结论本装置操作简单、使用过程安全,可实现无创和连续性测量腹内压,对腹透患儿临床透析处方有指导意义。
Objective To design an intra-abdominal pressure measuring device applied to children on peritoneal dialysis(PD),and evaluate the feasibility and safety of the application of the device.Methods The device consisted of a three-way stopcock with extension tubing,a three-way stopcock,a manometer tube,and a“Y”system peritoneal dialysis bag.The intraperitoneal pressure of different fill volumes was measured when a child was supine and relaxed in a horizontal position.The subjects of the study were children who received PD at the Pediatric Hospital of Fudan University from May 2019 to February 2020 and had PD dialysis age of>1 month.The children's demographic and clinical information were collected.During the measurement,the child’s complaints of pain,bloating,vital signs,and catheter-related contamination were recorded.Additionally,the occurrence of dialysis-related infections and complications during the hospitalization and outcomes of PD after three months of the measurement were tracked.A scatter plot and Pearson correlation test were used to explore the correlation between fill volumes and the intraperitoneal pressure.Results Nine PD children were included in our study.The age of the children was(8.4±4.7)years old.The body surface area is(0.84±0.29)m^(2).The intraperitoneal pressure was(12.6±1.9)cmH2O at the fill volume of 1000 ml/m^(2) and(13.8±1.9)cmH2O at the fill volume of 1200 ml/m^(2).The measurement was smoothly and safely taken without any case of contamination and dialysis-related infections during the hospitalization.After three months of the measurement,one child was transferred to temporary hemodialysis due to the aggravation of the umbilical hernia.Conclusions The intraperitoneal pressure measuring device is feasible and safe to perform among children with PD.It can achieve non-invasive and continuous measurement of intra-abdominal pressure,and has guiding significance for the dialysis prescription of children with PD.
作者
陆培
周清
沈霞
姚佩莲
沈茜
徐虹
方晓燕
赵蕊
Lu Pei;Zhou Qing;Shen Xia;Yao Peilian;Shen Qian;Xu Hong;Fang Xiaoyan;Zhao Rui(Nephrology Department,Children's Hospital of Fudan University,Shanghai 201102,China)
出处
《中华肾脏病杂志》
CAS
CSCD
北大核心
2021年第4期341-346,共6页
Chinese Journal of Nephrology
基金
上海市卫生和计划生育委员会科研课题(201940071)。
关键词
腹膜透析
腹膜腔
压力
儿童
设备设计
可行性
Peritoneal dialysis
Abdominal cavity
Pressure
Children
Equipment design
Feasibility
