【摘要】 选择16例晚期尿毒症患者经持续性不卧床腹膜透析(CAPD)治疗后病情稳定,改作间歇性全日腹膜透析(IWPD)6～36个月,大部分病人自我感觉良好,身心安宁,生活自理,保持CAPD期间的精神、食欲状态,体重、血压平稳,并且每周有5天休息。病人血生化参数(血红蛋白、白蛋白、钠、二氧化碳总量、Cr、中分子物质)稳定,血总蛋白升高,血钾、血尿素氮(BUN)、磷稍有下降,表明IWPD对小分子毒素的清除优于CAPD,对中分子的清除与CAPD相仿。IWPD可简化操作,接卸接头的次数大为减少,同时减少腹膜蛋白质丢失,患者血总蛋白提高,营养改善,细菌性腹膜炎发生率明显下降。IWPD除保留CAPD的优点外,费用较低,且省时,是治疗尿毒症病人有效方法之一,可试用于具备下列条件的尿毒症病人;①肌酐清除率(Ccr)≥4～5 ml/min;②CAPD4～5天/周可达到透析充分;③无高分解代谢表现,无明显心衰及顽固性高血压。更多还原

【Abstract】 According to the principle of CAPD, an improvement of peritoneal dialysis technique, referred to as intermittent whole-day peritoneal dialysis (IWPD), has been developed. This method is as follow. A total capacity of dialysate used in a week in CAPD is divided into two parts. Each part is divided to 10 exchanges. In dialysis day, the treatment is performed at 8, 10, 12, 14, 16,18, 20, 22 o’clock and 0, 4 o’clock the next morni-ing (once every 3 days ). Sixteen cases of chronic renal failure were included into our programme, and were treated for 6 to 36 months. The results showed: (1) In the most of patients, the general conditions were similar to those of CAPD patients. (2) In small molecular solutes and middle molecules (MM) clearance of peritoneum, IWPD was better and lost less protein than CAPD (P<0.001).(3) Blood parameters (Na+, Cl-,Ca2+,MM, TCO2, Hb, albumin) were kept stable. The levels of serum K+, P3-, and BUN were slightly lower than those of CAPD (P<0.001, 0.05, 0.01, respectively), while serum total protein (TP) concentration was increased (P<0.05). Seven patients’ serum Ca2+ levels were increased slightly after 2 years. (4) Because the connecting and disconnecting tubes was reduced from 20 times to 2 times a week, and patients serum TP levels increased, only 3 episodes of peritonitis occurred in 257 patient months. Our study has suggested thdt IWPD is as effective as CAPD and simpler than CAPD. The patients could live more freely and save more time. The cost of dialysis was lowered, and side-effect was reduced.更多还原