维持性血液透析在婴幼儿终末期肾病的应用

doi:10.3969/j.issn.1006-298X.2020.03.003

肾脏病与透析肾移植杂志

维持性血液透析在婴幼儿终末期肾病的应用

出版日期:2020-06-28 发布日期:2020-07-07

Application of maintenance hemodialysis in infants with endstage renal disease

Online:2020-06-28 Published:2020-07-07

摘要/Abstract

摘要： 目的：回顾性分析维持性血液透析（MHD）在婴幼儿中的应用，为低体重低年龄终末期肾病患儿开展MHD提供依据。
方法：回顾2017年1月～2019年10月复旦大学附属儿科医院肾内科收治的符合血液透析（HD）指征的婴幼儿，且家属签署知情同意书。分析患儿的原发疾病、并发症、导管留置时间、治疗前后效果及临床转归情况。
结果：共纳入15例婴幼儿，患儿置管顺利，共行226例次的HD治疗，治疗后患儿血清肌酐、尿素氮、血压、血钾等指标均较透析前明显下降（P＜005）。226例次HD中，透析相关并发症29例次（1283%），导管相关并发症10例次（442%），患儿半年存活率100％。13例患儿成功的过渡到腹膜透析，2例患儿放置隧道式带涤纶套中心静脉导管（28 cm）行长期HD治疗。
结论：MHD可以作为终末期肾病婴幼儿治疗的有效方法，且是安全可行的，为今后婴幼儿开展MHD治疗工作提供了正确的指导和帮助。

关键词: 维持性血液透析, 婴幼儿, 终末期肾病

Abstract: Ｏｂｊｅｃｔｉｖｅ：Aim to evaluate outcomes and complications of maintenance hemodialysis among infants/toddlers.
Ｍｅｔｈｏｄｏｌｏｇｙ：A retrospective study of infants/toddlers undergoing hemodialysis in our center from January 2017 to October 2019 was conducted.After obtaining the informconsents from parents,we retrieved and analyzed information such as primary diseases,vascular access,complications,and treatment outcomes from the hospitals electronic health record.
Ｒｅｓｕｌｔｓ：15 infants/toddlers were included in the analysis.They underwent 226 times of bedside hemodialysis,and their vascular catheters were smoothly placed.Children had reduced serum creatine concentration (SCr),blood urea nitrogen (BUN),and blood pressure after every hemodialysis session (P<0005).Among 226 sessions,there were 29 (1283%) episodes of dialysisrelated complications and 10 (442%) episodes of catheterrelated complications.Sixmonth survival rate was 100%.13 children transferred to peritoneal dialysis and 2 were on longterm hemodialysis with tunneled catheters (28 cm).
Ｃｏｎｃｌｕｓｉｏｎ：With appropriate dialysis orders and devices,the maintenance hemodialysis could be a safe and effective treatment among children less than 3 years old.The study may serve as a reference in the maintenance hemodialysis for infants/toddlers in other centers.

Key words: maintenance hemodialysis, infants and toddlers, end-stage renal disease

张慧,顾莺,赵蕊,等. 维持性血液透析在婴幼儿终末期肾病的应用[J]. 肾脏病与透析肾移植杂志, DOI: 10.3969/j.issn.1006-298X.2020.03.003.

ZHUANG Hui，GU Ying，ZHAO Rui，et al. Application of maintenance hemodialysis in infants with endstage renal disease[J]. Chinese Journal of Nephrology, Dialysis & Transplantation, DOI: 10.3969/j.issn.1006-298X.2020.03.003.

[1]	甘言刚, 赵明明, 滕洁, 夏文亚, 张颖, 冯锦红, 孙东. 维持性血液透析患者左心室舒张功能障碍的危险因素及预测模型[J]. 肾脏病与透析肾移植杂志, 2021, 30(1): 31-36.
[2]	蒲蕾,杨鸿玲,何强,李贵森,冯韵霖. 容量评估预测维持性血液透析患者预后的价值[J]. 肾脏病与透析肾移植杂志, 2020, 29(6): 508-513.
[3]	梁顺添,梁永红,冯超,陈清,周忠信. CT/DSA双重引导下经腰部置入下腔静脉隧道性涤纶透析导管[J]. 肾脏病与透析肾移植杂志, 2020, 29(6): 589-593.
[4]	王惠明. 血液透析中心新型冠状病毒肺炎的防治[J]. 肾脏病与透析肾移植杂志, 2020, 29(5): 456-457.
[5]	ACTIVE研究工作组. 西那卡塞治疗中国维持性血液透析继发性甲状旁腺功能亢进的多中心临床研究（ACTIVE）方案[J]. 肾脏病与透析肾移植杂志, 2020, 29(5): 478-483.
[6]	汪博,杜瑞妮,阳婷婷,高媛,李亚娟,高巍. 肾移植围手术期容量管理研究进展[J]. 肾脏病与透析肾移植杂志, 2020, 29(5): 489-493.
[7]	邓中凤,陈萍,邹杨. 隐匿性乙型肝炎病毒感染血液透析患者的分子特性及转归[J]. 肾脏病与透析肾移植杂志, 2020, 29(4): 328-.
[8]	陈颖,沈毅,贾玉敏,等. 糖尿病患者维持性血液透析生存分析及预测模型构建[J]. 肾脏病与透析肾移植杂志, 2020, 29(3): 201-207.
[9]	张继强，陈峥，常保超，等. 应用腔内血管成形术更换血液透析长期导管[J]. 肾脏病与透析肾移植杂志, 2020, 29(2): 130-135.
[10]	阳晓. 紧急腹膜透析在终末期肾病中的应用[J]. 肾脏病与透析肾移植杂志, 2020, 29(2): 144-145.
[11]	张晓辉. 紧急起始腹膜透析临床应用的体会[J]. 肾脏病与透析肾移植杂志, 2020, 29(2): 146-147.
[12]	池向耿,蔡琪,陈艳转,等. 维持性血液透析患者缺铁性贫血的危险因素及列线图模型建立[J]. 肾脏病与透析肾移植杂志, 2019, 28(6): 538-543.
[13]	赵卫红，柏云，裴小华. 老年终末期肾病治疗的选择：透析还是保守[J]. 肾脏病与透析肾移植杂志, 2019, 28(6): 546-547.
[14]	杨璨粼,刘玉秋,张晓良. 透析患者钙化防御的治疗[J]. 肾脏病与透析肾移植杂志, 2019, 28(6): 580-585.
[15]	刘喆,赵闻雨,朱有华, 等. 肾移植患儿生长发育障碍[J]. 肾脏病与透析肾移植杂志, 2018, 27(6): 581-584.

ISSN 1006-298X CN 32-1425/R

维持性血液透析在婴幼儿终末期肾病的应用

Application of maintenance hemodialysis in infants with endstage renal disease

PDF

可视化

摘要/Abstract

引用本文

使用本文

参考文献

相关文章 15

编辑推荐

Metrics

本文评价