持续缓慢低效血液透析患者应用枸橼酸抗凝的护理.pdfVIP

• 978 • 中华护理杂志 2013 年 11 月第 48 卷第 11 期 Chin J Nurs ,Novemher 2013 ,Vol 48 ,No.11 持续缓慢低效血液透析患者应用拘橡酸抗凝的护理 陈志文王星代明金王蓓蓓周丹张雪梅刁永书张凌 [摘要] 总结45例急性肾损伤或终末期肾脏疾病患者采用构橡酸抗凝行持续缓慢低效血液透析(SLED) 治疗的效果及护理体 会。护理要点包括:保证机器的正常运转，确保外周液体补入位置的准确，密切监测血电解质及并发症护理。经治疗与护理，45例 患者行SLED治疗 162例次，除2例次分别在治疗4h及6h 时出现过1 ì.欠滤器皿。凝血需更换透析管路外，余160例次均顺利完成。 【关键词] 肾疾病; 护理; 抗凝药; 构橡酸; 持续缓慢低效血液透析 Nursing care of patients with sustained low efliciency dialysis (SLED) by using citrate anticoagulantJCHEN Zhi-wen , WANG Xing ,DAI Ming才in ， WANG Bei-bei ,ZHOU Dan ,ZHANG Xue-mei ,DIAO Yong-shu ,ZHANG Ling [Abstract] This paper summarizes the nursing care of 45 patients with acute kidney injury(AKI) or end stage renal disease (ESRD) receiving sustained low efficiency dialysis ( SLED) by using citrate anticoagulant in West China Hospital , Sichuan University from August 2011 to September 2012. The key points in nursing were promptly taking good c缸e of the machines , close monitoring of blood electrolytes ,prevention and nursing of complications. As a result ,45 patients underwent 162 sessions of SLED. Two sessions were discontinued for filter coagulation , and the rest 160 SLED sessions were all successfully performed. [Key words 1 Kidney Disease; Nursing Care; Anticoagulants; Citrate; Sustained low efficiency dialysis 持续缓慢低效血液透析(sustained low efficiency dialysis , 末期肾脏疾病患者中，合并心功能不全8例、呼吸衰竭11 例、 SLED)是一种介于连续性肾脏替代治疗(continuous renal 血流动力学不稳定3例、容量控制不佳5例及老年患者3例(年 replacement therapy , CRRT) 与间歇性血液透析(intermittent 龄60岁)。 hemodialysis ,IHD )之间的新型杂合式肾脏替代治疗模式。其 1.2 治疗方法 特点是以延长、缓慢、低效、低流量为主，杂合CRRT及IHD的 所有患者均采用费森尤斯4∞8sARrTplus 透析机行 优势，用价格低廉的普通血液透析机达到平稳高效的血液净 S皿D ，每次治疗8h ，透析器采用Polyflux 14L( 金宝)，血管通 化效果[IJ 。拘橡酸作为一种较受推崇的新型抗凝方式，其抗凝 路均采用颈(股)