摘要
自动化腹膜透析(automated peritoneal,APD)因其便利性、灵活性的优势,正成为越来越多终末期肾病(end stage renal disease,ESRD)患者的选择,尤其是青壮年、婴幼儿、老年及溶质清除不充分、反复腹膜炎的患者。在紧急透析方面,APD有利于减少腹膜透析相关并发症且更节省人力。由于APD血流动力学影响小、不需要抗凝和体外循环、医疗风险和成本相对较低,国内外部分研究者成功将APD用于合并ESRD的多种临床危重症的治疗,如充血性心力衰竭、急性心脑血管病变、急性胰腺炎等。床旁穿刺置管技术的发展极大推动了APD在急性肾损伤(acute kidney injury,AKI)治疗中的应用,但仍需高质量的临床研究观察比较APD与血液透析治疗AKI的有效性和安全性。同时,作为一种新兴腹膜透析模式,APD在腹腔感染的诊治、水的清除及营养状况影响等方面还需要更深入的研究。
Because of the advantages of convenience and flexibility,automated peritoneal dialysis(APD)is becoming the choice for many end-stage renal disease(ESRD)patients,especially for those of young adults,infants,elderly,and peritoneal dialysis patients with inadequate clearance of solutes and recurrent peritonitis.APD has the advantages of labor-saving and prevention of peritoneal dialysis associated complications,and can be used in urgent start dialysis.APD has less hemodynamic disturbance and does not need anticoagulant and extracorporeal circulation,with lower medical risks and expenses.Recently,APD has been successfully used in the treatment of many acute and severe diseases,such as congestive heart failure,acute cardio-cerebrovascular disease and acute pancreatitis.Percutaneous catheterization at bedside facilitates the application of APD in acute kidney injury patients,but the efficacy and safety need to be further studied by comprehensive comparisons of APD and hemodialysis.As a new dialysis modality,APD in peritonitis diagnosis and treatment,water clearance and nutritional influence remain unknown and more investigations are required.
作者
马莹
王颖
陈丽萌
MA Ying;WANG Ying;CHEN Li-meng(Department of Nephrology,Peking Union Medical College Hospital,Chinese Academy of Medical Science,Beijing 100730,China)
出处
《中国血液净化》
CSCD
2019年第3期149-152,共4页
Chinese Journal of Blood Purification
基金
中国医学科学院医学与健康科技创新工程(2016-I2M-2-004)
中国医学科学院协和学者特聘教授基金
关键词
自动化腹膜透析
急危重症
紧急透析
终末期肾脏病
急性肾损伤
Automated peritoneal dialysis
Intensive medicine
Urgent start dialysis
End-stage renal disease
Acute kidney injury
作者简介
通信作者:陈丽萌,100730,北京,北京协和医院肾内科,Email:chenlpumch@163.com.
