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目的:观察腹膜透析治疗小儿先心病术后低心排血量综合征的疗效果。方法:61例先心病术后并发低心排血量综合征患儿,于腹膜透析前后以心脏超声测定心腔内径、左室射血分数、肺动脉压力变化,另测定中心静脉压、尿量、血气分析指标、血浆脑型利钠肽浓度评估腹膜透析的影响。结果:与治疗前相比,尿量[(203.28±15.81)ml比(989.11±54.72)ml]显著增多,左室射血分数显著提高[(32.94±2.29)%比(51.93±2.79)%];而肺动脉压[(46.72±3.84)mmHg比(34.82±2.92)mmHg]、中心静脉压[(17.27±1.47)cmH2O比(10.41±1.01)cmH2O],血浆脑型利钠肽水平[(5928.71±158.27)ng/ml比(3851.83±128.81)ng/ml]显著下降,P均<0.001,。结论:腹膜透析可有效治疗先心病术后低心排血量综合征,这与其超滤、减轻心脏负担等作用有关。
Objective: To observe the effect of peritoneal dialysis on low cardiac output syndrome after pediatric congenital heart disease (CHD). Methods: Sixty-one children with congenital heart disease (CHD) complicated with low cardiac output syndrome were included in this study. The intracardiac diameter, left ventricular ejection fraction and pulmonary artery pressure were measured before and after peritoneal dialysis. The central venous pressure, Blood gas analysis index, plasma brain natriuretic peptide concentration to assess the impact of peritoneal dialysis. Results: Compared with those before treatment, the urine volume increased significantly ([(32.94 ± 2.29)% vs (51.93 ± 2.79)%] (203.28 ± 15.81 ml vs 989.11 ± 54.72 ml, (46.72 ± 3.84 mmHg vs 34.82 ± 2.92 mmHg), central venous pressure (17.27 ± 1.47 cmH2O vs 10.41 ± 1.01 cmH2O), plasma brain natriuretic peptide level (5928.71 ± 158.27) ng / ml (3851.83 ± 128.81) ng / ml] significantly decreased, P <0.001. CONCLUSION: Peritoneal dialysis can effectively treat low cardiac output syndrome after congenital heart disease, which is related to the effects of ultrafiltration and reducing the burden of heart.