自动化腹膜透析在终末期糖尿病肾病患者中适用性研究.docVIP

自动化腹膜透析在终末期糖尿病肾病患者中适用性研究 　　[摘要] 目的 ?^察在终末期糖尿病肾病腹膜透析患者中以夜间间歇性自动化腹膜透析（NIPD）代替普通持续性非卧床腹膜透析（CAPD）的可行性。 方法 将选取的48例CAPD方案行腹膜透析的患者按照随机数字表法分为观察组及对照组，收集两组患者入院时年龄、性别、体重、腹透时间等基本资料，同时检测并计算患者体重指数，血及腹透液尿素、肌酐，患者收缩压、舒张压、尿量，腹透每日超滤量，血钠、血浆白蛋白，残肾Kt/V，总Kt/V及总肌酐清除率值。然后观察组患者予NIPD模式透析14 d，而对照组予CAPD模式共透析14 d。再次检测并计算上述两组数据，分析两种透析方案在患者中的疗效差别。 结果 观察组在使用NIPD方案后，在透析容量控制方面，24例入组患者体重指数、收缩压、舒张压、腹透每日超滤量4项的前后对比差异有统计学意义（P0.05）。在透析毒素排泄方面，患者血尿素、血肌酐、残肾Kt/V、总Kt/V及总肌酐清除率值无明显统计学差异（P0.05）。而腹透液尿素及肌酐在更换NIPD后有实际下降，差异有统计学意义（P0.05）。对照组在持续使用CAPD方案透析后，各项数据前后未有明显变化。结论 在终末期糖尿病肾病腹膜透析患者中，NIPD比CAPD在透析容量控制上有明显优势，但在透析毒素清除率上有待进一步的观察及研究。 　　[关键词] 夜间间歇性自动化腹膜透析（NIPD）；糖尿病肾病；持续性非卧床腹膜透析（CAPD）；容量控制 　　[中图分类号] R459.5 [文献标识码] A [文章编号] 1673-9701（2017）09-0023-05 　　Observation of the efficacy of automatic peritoneal dialysis in the patients with end-stage diabetic nephropathy 　　JIN Yiming SHEN Weigang ZHU Shenghong KONG Shibo HE Min’er 　　Department of Nephrology， Shaoxing Second Hospital， Shaoxing 312000， China 　　[Abstract] Objective To evaluate the feasibility of nocturnal intermittent automatic peritoneal dialysis （NIPD） replacing conventional continuous ambulatory peritoneal dialysis（CAPD） in the patients with end-stage diabetic nephropathy. Methods The 48 patients with CAPD were randomly divided into observation group and control group according to random number table method， The age， sex， weight， dialysis time and other basic information of the two groups were collected， at the same time the body mass index of patients， blood and dialysate urea， creatinine， systolic blood pressure， diastolic blood pressure， urine volume， daily peritoneal ultrafiltration volume， blood sodium， plasma albumin， residual kidney Kt/V， total Kt/V and creatinine clearance value were detected and calculated. Then the patients in the observation group were treated with NIPD mode for 14 days， while the control group was treated with CAPD mode for 14 days. The above data were again detected and calculated， and the difference of curative effect between