【摘要】 目的：探讨自动腹膜透析（automatic peritoneal dialysis,APD）治疗尿毒症合并心力衰竭患者的临床效果及安全性。方法：选择开平市中心医院内一科2016年5月-2020年5月维持性腹膜透析尿毒症合并心力衰竭患者228例进行回顾性分析，根据治疗方式分为APD组112例和手工间歇性腹膜透析组（IPD组）116例，治疗2周，比较两组心功能指标[左室射血分数（LVEF）、心脏指数（CI）、心排血量（CO）及脑钠肽（BNP）]、毒素指标[血肌酐（Scr）、血尿素氮（BUN）、血钾及血磷]、基本日常生活能力（BADL）和工具性日常生活活动能力（IADL）。结果：治疗2周后，APD组和IPD组LVEF、CI和CO明显高于治疗前，BNP明显低于治疗前，且APD组的LVEF、CI和CO明显高于IPD组，BNP明显低于IPD组，差异有统计学意义（P<0.05）；治疗2周后，两组Scr、BUN、血钾、血磷均较治疗前下降，APD组的Scr、BUN低于IPD组，差异有统计学意义（P<0.05）；治疗前，两组BADL、IADL评分比较，差异无统计学意义（P>0.05），治疗2周后，两组BADL及IADL评分均高于治疗前（P<0.05）,APD组的IADL评分显著高于IPD组（P<0.05）；两组并发症发生率比较，差异无统计学意义（P>0.05）。结论：与IDP相比，APD治疗能够显著改善尿毒症合并心力衰竭的临床心功能，减轻毒素指标，改善生活能力，具有重要的临床应用意义。更多还原

【Abstract】 Objective: To investigate the clinical efficacy and safety of automatic peritoneal dialysis(APD) in patients with uremia complicated with heart failure. Method: A retrospective analysis was performed on 228 patients with uremia complicated with heart failure on maintenance peritoneal dialysis from May 2016 to May 2020 in Internal Medicine Department One of Kaiping Central Hospital.According to the treatment the patients were divided into APD group of 112 cases and manual intermittent peritoneal dialysis group(IPD group) of 116 cases, treatment for two weeks, the cardiac function indexes [left ventricular ejection fraction(LVEF), cardic index(CI),cardic output(CO) and brain natriuretic peptide(BNP)], toxin indexes [serum creatinine(Scr), blood urea nitrogen(BUN), blood potassium and blood phosphorus], basic activities of daily living(BADL), instrumental activities of daily living(IADL) were compared between two groups. Result: After two weeks of treatment, LVEF, CI and CO in APD group and IPD group increased significantly higher than before treatment, BNP was lower than before treatment, LVEF, CI and CO in APD group were significantly higher than those in IPD group, while BNP was significantly lower than that in IPD group, the differences were statistically significant(P<0.05). After two weeks of treatment,Scr, BUN, blood potassium and blood phosphorus in the two groups were decreased compared with before treatment, Scr and BUN in APD group were lower than IPD group, the differences were statistically significant(P<0.05). There were no significant differences in BADL and IADL scores between the two groups before treatment(P>0.05). After two weeks of treatment, BADL and IADL scores in both groups were higher than before(P<0.05), while IADL score in APD group was significantly higher than that in IPD group(P<0.05). There was no significant difference in incidence of overall complications between two groups(P>0.05). Conclusion: Compared with IDP, APD treatment can significantly improve clinical cardiac function, reduce toxin index and improve living ability in uremia complicated with heart failure,which has important clinical application significance.更多还原