Hemodialysis 还是Peritoneal dialysis比较好？

blueskyline

请问这里有医药专护人员可以给我意见吗？我的婆婆， 75岁了，患有多年高血压，长期服药，近期有心脏病，昨天医生说她的肾功能坏了，最坏打算是洗肾。
我想请问各位，或有这方面知识的人告诉我两种方法，哪一个较适合我婆婆？我是biotech生，一些医药名词我还可以。请你们帮帮忙。
我看了很多journal, 但没有针对马来西亚及我婆婆的个人案例。我在外坡工作，不能回家，我问不到医生。会的人请帮帮我!!

shanghanlun

西医没告诉你，你婆婆好端端的肾脏为什么会变坏了？

:

blueskyline

原帖由 shanghanlun 于 1-6-2009 02:24 PM 发表
西医没告诉你，你婆婆好端端的肾脏为什么会变坏了？

:

他说这是心脏病和高血压的后遗症。

jinreung

刚才尝试寻找以前慢郎中大人的帖，结果却找不到
其实不需要找马来西亚的个案，问题是你婆婆的情况是否紧急，血压、呼吸是否稳定，还有是否出现其他并发症，最近有没有动过任何大型的手术。

既然你是biotech生，请慢慢看
http://lib.bioinfo.pl/meid:255719

The management of patients with acute renal failure (ARF) is very complex and requires meticulous attention to fluid, acid-base and electrolyte balance as well as the removal of uraemic toxins. Peritoneal dialysis (PD) is an important option for treatment of selected patients with ARF, particularly those who are haemodynamically compromised or have coagulation abnormalities. Due to continuous therapy, its efficacy is the same as on haemodialysis, even better. Advantages of PD in ARF therapy: it is widely available and easy to perform; insertion of PD catheter is relatively easy, PD does not require special staff or expensive equipment, arterial or venous puncture and anticoagulation; dosing is easy; there is no interaction between blood and dialyser and there are no episodes of hypotension like in haemodialysis (HD) patients; acid-base and electrolyte imbalance may be easily and gradually corrected, large amounts of fluid can be removed in haemodynamically unstable patients, which allows parenteral nutrition. PD is less efficient than HD in therapy of acute complications (pulmonary oedema, intoxication or hyperkaliaemia) and is not the therapy of choice in patients with extreme catabolism who require daily HD or some other kind of continuous renal replacement therapy. The absolute indication for acute PD is the need for dialysis and inability to perform any other renal replacement technique. Relative indications for acute PD in adults are the following: haemodynamically unstable patients, the presence of bleeding or haemorrhagic conditions, difficulty in obtaining vascular approach, removal of high molecular weight toxins, heart failure refractory to medical treatment. Absolute contraindications for PD are the following: recent abdominal or cardiothoracic surgery, diaphragmatic peritoneal-pleural connections, faecal or fungal peritonitis. Other contraindications are relative. Accordingly, acute PD is the mode of therapy in some specific patients with ABI, especially patients in intensive care units. Survival of ARF patients is similar in PD and HD patients, so acute PD is very important in their therapy.

shanghanlun

原帖由 blueskyline 于 1-6-2009 02:34 PM 发表


他说这是心脏病和高血压的后遗症。

那位西医怎么回答得那么轻率!
你有想过为什么会有后遗症吗?真的是心脏病和高血压造成的吗?

@res

那你知道为什么吗？
请问'shanghanlun版'的高血压和心脏病的后遗症是什么？pathogenesis是怎样？哦，对了，pathogenesis，你明白是什么吗？
你又有什么高见？怎么医？是不是用你的“神之指“点一点，病人就会好？你的大师是这样教你的吗？好神奇哦。。。
只会批评人，不过自己也没有给什么建议。。。

[ 本帖最后由 @res 于 1-6-2009 06:03 PM 编辑 ]