日间非卧床腹膜透析对ESRD患者容量负荷的影响

目的探讨日间非卧床腹膜透析(DAPD)及持续非卧床腹膜透析(CAPD)对ESRD患者容量负荷的影响。方法选我院肾内科行腹膜透析患者36例,随机分成DAPD组(A组)与CAPD组(B组)2组,A组16例,采用DAPD模式,即日间采用8 L的透析剂量,4次交换,每4⁵ h交换一次透析液,夜间干腹;B组20例,采用CAPD模式,每天的透析剂量为8 L,4次交换,每45 h交换一次透析液,夜间干腹;B组20例,采用CAPD模式,每天的透析剂量为8 L,4次交换,每4⁵ h交换一次透析液,夜间留腹。随访2年,记录2组患者体质量及体质量指数(BMI)、血压、心胸比、左心室后壁厚度、室间隔厚度、血红蛋白、血清白蛋白等指标,比较2组患者透析充分性,包括尿素清除指数[Kt/V(周)]、肌酐清除率(Ccr),实验数据以(χ—±s)表示,两组定量资料间的比较采用t检验,P<0.05表示差异有统计学意义。结果 A、B两组患者在残余尿量、透析充分性[Kt/V(周)、Ccr]、血红蛋白、血清白蛋白等方面比较差异无统计学意义(P>0.05);A组在血压、体质量增加量、超滤量、心胸比、左心室后壁厚度、室间隔厚度等方面均优于B组,差异有统计学意义(P<0.05)。结论在使用相同透析剂量的情况下,行DAPD治疗的患者比CAPD患者在容量负荷方面有更满意的临床疗效。

Effect of Daytime Ambulatory Peritoneal Dialysis on Volume Load in ESRD Patients

Objective To explore the effect of both daytime ambulatory peritoneal dialysis （DAPD） and continuous ambulatory peritoneal dialysis （CAPD） on volume load in ESRD patients. Methods A total of 36 patients subjected to peritoneal dialysis in our hospital were selected and randomized into group A （n=16） and group B （n=20）. Patients in group A were treated with DAPD by using 8 L dialysate at daytime, dialysate exchange every 4-5 hours, and evacuation of dialysate from abdomen at night. Patients in group B were treated with CAPD by using the dialysate 8 L/day, four exchanges per day, dialysate exchange every 4-5 hours, and dialysate left in abdomen cavity at night. A 2-years monitoring for the patients was carried out. Thoroughness of dialysis was compared between the two groups, including the changes of body weight,urine output, amount of ultraifltration, urea clearance index （Kt/V）, creatinine clearance rate （Ccr）, serum albumin （sALB）, hemoglobin （Hb）, mean arterial blood pressure, the ratio of thorax-heart, LVPWT and IVST. Data were presented as mean±SD, and t-test for the comparison between two groups. P〈0.05 was considered to be statistically signiifcant. Results Residual urinary volume, Kt/V （weeks）, Ccr, sALB and Hb were statistically insignificant between the two groups （P＆gt;0.05）. However, the changes of body weight, ultraifltration volume, mean arterial blood pressure, the ratio of thorax-heart, LVPWT and IVST were better in group A than in group B （P〈0.05）. Conclusion Patients under DAPD had better clinical efifcacies than those under CAPD in volume stutas, although the dialysate volume used was similar in the two groups.