【摘要】 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4~5 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4~5 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。更多还原

【Abstract】 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 ultrafiltration, 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 significant. Results Residual urinary volume, Kt/V(weeks), Ccr, sALB and Hb were statistically insignificant between the two groups(P >0.05). However, the changes of body weight, ultrafiltration 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 efficacies than those under CAPD in volume stutas, although the dialysate volume used was similar in the two groups.更多还原