邓丽贞 黄佳丽 黄力

【摘要】 目的：探讨慢性肾衰竭患者采取小剂量初次腹膜透析治疗的临床效果。方法：选取2016年2月-2018年2月本院收治的慢性肾衰竭患者66例，按照随机数字表法将其分为研究组和对照组，各33例。两组均接受初次腹膜透析治疗，对照组采取常规剂量，研究组采取小剂量，均治疗3个月后测定患者的肾功能指标（Scr、Hb、尿量、BUN、ALB），记录并发症发生情况。结果：研究组Scr低于对照组，Hb、尿量均高于对照组，差异均有统计学意义（P<0.05），但两组BUN、ALB比较，差异均无统计学意义（P>0.05）;两组均有并发症发生，包括腹膜感染、低蛋白血症、心绞痛、脑卒中，研究组并发症发生率为9.09%，显著低于对照组的27.27%（P<0.05）。结论：慢性肾衰竭患者采取小剂量初次腹膜透析治疗，相比常规剂量治疗，可更好地改善Scr、Hb、尿量等肾功能指标，而且并发症少，安全性更高，值得推广应用。

【关键词】 慢性肾衰竭; 小剂量; 常规剂量; 初次腹膜透析; 肾功能

【Abstract】 Objective：To investigate the clinical effect of low dose initial peritoneal dialysis in patients with chronic renal failure.Method：A total of 66 patients with chronic renal failure admitted to our hospital from February 2016 to February 2018 were selected.According to the random number table method，they were divided into study group and control group，33 cases in each group.They were treated with initial peritoneal dialysis，while control group was treated with regular dose and study group was treated with low dose.The renal function indexes（Scr，Hb，urine volume，BUN，ALB）of the patients were measured after 3 months of treatment，and the complications were recorded.Result：The Scr in study group was lower than that of control group，Hb and urine volume were higher than those of control group，the differences were statistically significant（P<0.05），but the BUN and ALB in two groups were compared，the differences were not statistically significant（P>0.05）.Complications occurred in both groups，included peritoneal infection，hypoproteinemia，angina pectoris and stroke，the incidence of complications in study group was 9.09%，significantly lower than 27.27% of control group（P<0.05）.Conclusion：Compared with regular dose，low dose initial peritoneal dialysis can improve renal function indexes such as Scr，Hb and urine volume，it has fewer complications and higher safety，it is worth popularizing and applying.

【Key words】 Chronic renal failure; Low dose; Regular dose; Initial peritoneal dialysis; Renal function

First-authors address：Zhaoqing First Peoples Hospital，Zhaoqing 526020，China

doi：10.3969/j.issn.1674-4985.2019.11.027

慢性腎衰竭属于一种持续发展、不可逆的肾脏慢性损伤疾病，本病主要表现为肾脏功能减退，伴有水电解质、酸碱紊乱及代谢产物潴留等，甚至部分患者会出现内分泌功能异常。众所周知，人体肾脏具有较强的储备功能，早期肾损伤症状一般不典型，若出现肾损伤典型症状及相关并发症时，则处于难以逆转状态，危害极大[1]。基于此，针对慢性肾衰竭的治疗关键在于尽早发现、诊断及治疗，做好并发症的积极预防，在一定程度上才能提高治疗效果，减少并发症发生，改善患者的生存质量[2]。慢性肾衰竭治疗以改善症状、延缓病情发展及保护残余肾功能为目的。腹膜透析治疗在近几年逐渐成熟起来，对维持生命，改善生活质量意义重大[3-5]。为了进一步探讨小剂量初次腹膜透析治疗慢性肾衰竭的临床疗效，本院就2016年2月-2018年2月收治的66例患者实施了分组研究，现报道如下。……