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护理风险因素分析对ICU患者行连续性肾脏代替治疗非计划性下机时间的影响

作者:王晓艳

所属单位:广东省韶关市南雄市人民医院ICU (广东 韶关 512400)

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摘要

目的 研究ICU患者行连续性肾脏代替治疗实施护理风险因素分析对非计划性下机时间的影响。方法 选择我院重症 监护病房(ICU)实施连续性肾脏代替疗法(CRRT)患者60例,随机分为观察组和对照组各30例,其中对照组使用常规 护理,研究则组在此基础上实施危险因素分析护理,均护理至正常出院。观察两组患者护理干预后两组患者管路使 用时间、入住ICU时间及非计划性下机时间,并统计两组护理期间非计划性下机次数及原因。结果 观察组管路使用 时间高于对照组(P<0.05);观察组入组ICU时间及非计划下机例数均低于对照组(P<0.05)。观察组非计划性下机 次数低于对照组(P<0.05),其中两组跨膜压过高、滤器出现Ⅱ或Ⅲ级凝血发生次数相当(P>0.05),观察组无法排 除警报停机发生次数低于对照组(P<0.05)。结论 ICU患者行连续性肾脏代替治疗实施护理风险因素分析主要是通 过减少非计划下机次数,进而缩短非计划性下机时间。

Objective To study the effects of nursing risk factors analysis on unscheduled interruption time of ICU patients undergoing continuous renal replacement therapy. Methods 60 patients in the intensive care unit(ICU) of our hospital who were treated with continuous renal replacement therapy(CRRT) were selected and randomly divided into observation group and control group, with 30 cases in each group. Control group was given routine nursing, and observation group was given risk factors analysis and nursing on this basis, and they were nursed until normal discharge. The pipeline use time, ICU stay and unscheduled interruption time were observed in the two groups after nursing intervention, and the frequency and reasons of unscheduled interruption during nursing were counted in the two groups. Results The pipeline use time in observation group was higher than that in control group(P<0.05). The ICU stay and the number of cases of unscheduled interruption in observation group were lower than those in control group(P<0.05). The frequency of unscheduled interruption in observation group was lower than that in control group (P<0.05). The high transmembrane pressure and the frequency of grade II or III coagulation occurred in filter were similar in the two groups(P>0.05), and the number of interruption which could not rule out the alarm reason in observation group was lower than that in control group (P<0.05). Conclusion Nursing risk factors analysis for ICU patients undergoing continuous renal replacement therapy is mainly to shorten unscheduled interruption time by reducing frequency of unscheduled interruption.

【关键词】连续性肾脏代替治疗;护理风险因素;危重症;ICU

【中图分类号】R59

【文献标识码】A

【DOI】10.3969/j.issn.1009-3257.2019.03.033

前言

重症监护病房(intensive care unit,ICU)主要 是为重症及昏迷提供隔离场所及治疗设备,其中连 续性肾脏代替疗法(continuous renal replacement therapy,CRRT)患者较为常见。CRRT可代替受损肾脏 清除危重患者体内废物,并维持酸碱及电解质平衡, 防止患者出现多器官衰竭,其血流动力学较稳定、溶 质及严重清除率均较高,临床应用较广泛[1]。近年有研究发现,CRRT治疗患者常因多种原因引起治疗时间 及治疗量不达标,出现非计划性下机现象,不仅增加 患者治疗费用及护理工作量,同时对治疗效果造成较 大影响[2]。基于此,本研究对ICU患者行连续性肾脏 代替治疗实施护理风险因素分析,观察其对非计划性 下机时间影响,现将研究结果报道如下。