Kohli H S, Arora P, Kher V, Gupta A, Sharma R K, Bhaumik S K
Department of Nephrology, SGPGIMS, Lucknow, India.
Ren Fail. 1995 Jan;17(1):51-6. doi: 10.3109/08860229509036375.
Thirty-one infants and children with acute failure were treated with peritoneal dialysis using a surgically placed Tenckhoff catheter. In 10 patients a peritoneal dialysis cycler was used, and 21 were dialyzed by the manual method. Initially, hourly exchanges were given for 24 to 48 h and, as the patients stabilized, 10 exchanges per day at 1-h intervals were given. The mean stabilization period was 36 +/- 8 h. The predialysis mean serum creatinine was 5.8 +/- 1.8 mg% and the serum creatinine while on daily dialysis was 2.8 +/- 1.1 mg%. Peritoneal dialysis succeeded in controlling metabolic abnormalities and improving fluid balance. All the catheters except one functioned immediately following insertion. Median duration of catheter placement for dialysis was 18 days (range 2 to 90). The incidence of peritonitis was 12.8%, and exit site infection was 6.4%. The infection rate was decreased when a cycler was used compared with the manual method (23.8% vs. 10.0%), though not statistically significant. Two patients developed hypothermia while being dialyzed via the manual method. To conclude, 10 daily peritoneal dialysis exchanges performed at 1-h intervals after initial stabilization using a surgically placed Tenckhoff catheter is an effective and safe mode of dialytic therapy for children with acute renal failure. Complications (infection and hypothermia) are reduced with the use of a cycler.
31例急性肾衰竭婴幼儿及儿童采用手术置入Tenckhoff导管进行腹膜透析治疗。10例患者使用腹膜透析循环器，21例采用手工方法进行透析。最初，每小时进行一次交换，持续24至48小时，随着患者病情稳定，改为每天10次交换，间隔1小时。平均稳定期为36±8小时。透析前平均血清肌酐为5.8±1.8mg%，每日透析时血清肌酐为2.8±1.1mg%。腹膜透析成功控制了代谢异常并改善了液体平衡。除一根导管外，所有导管插入后立即发挥作用。透析导管置入的中位持续时间为18天（范围2至90天）。腹膜炎发生率为12.8%，出口部位感染率为6.4%。与手工方法相比，使用循环器时感染率有所降低（23.8%对10.0%），但差异无统计学意义。2例患者在采用手工方法透析时出现体温过低。总之，对于急性肾衰竭儿童，在最初病情稳定后，使用手术置入的Tenckhoff导管，每天间隔1小时进行10次腹膜透析交换是一种有效且安全的透析治疗方式。使用循环器可减少并发症（感染和体温过低）。
