70例砷中毒重症患者行血液透析联合血液灌流治疗的护理.docVIP

精品论文 参考文献 70例砷中毒重症患者行血液透析联合血液灌流治疗的护理 哈尔滨市阿城区人民医院 黑龙江哈尔滨 150300 【摘 要】目的：探讨血液透析联合血液灌流对砷中毒重症患者治疗的护理。方法：行血液透析联合血液灌流并予以护理。整个治疗过程在ICU完成，密切观察病情变化，全力维持患者生命体征的稳定。并针对病情变化给予相应的护理，包括心理的护理，营养的护理以及解毒药物不良反应的观察及护理。结果：70例砷中毒重症患者通过积极治疗和护理，患者病情日益好转，6例患者治疗后恶心、呕吐、腰痛、腹痛、肾区叩击痛及酱油色尿均明显缓解，尿色正常，3例肾功能明显好转，无需进一步选择HD治疗，其余患者仍维持HD治疗2～8次，均痊愈出院，未留后遗症。结论：对于砷中毒的重症患者，行血液透析联合血液灌流的护理有利于病情的好转，且未发生并发症，顺利转出ICU。 【关键词】砷中毒；血液透析联合血液灌流；护理 Nursing of hemodialysis combined with hemoperfusion in 70 patients with severe arsenic poisoning Abstract：Objective：To explore the nursing of hemodialysis combined with hemoperfusion in the treatment of severe arsenic poisoning.Methods：Hemodialysis combined with hemoperfusion and nursing.The entire treatment process in the ICU completed，close observation of changes in condition，to maintain the stability of vital signs in patients.And to give the appropriate changes in condition care，including psychological care，nutrition，care and detoxification of adverse reactions observed and care.Results：70 cases of severe arsenic poisoning patients through aggressive treatment and care，the patients condition improved day by day，6 patients after treatment nausea，vomiting，back pain，abdominal pain，kidney tapping pain and soy color urine were relieved，urine normal，3 Renal function improved significantly，without further choice of HD treatment，the remaining patients still maintain HD treatment 2 to 8 times，were cured，without leaving sequelae.Conclusion：The nursing of hemodialysis combined with hemoperfusion is beneficial to the improvement of the patients with severe arsenic poisoning，and no complication happened. Key words：arsenic poisoning；hemodialysis combined with hemoperfusion；nursing. 砷是一种严重危害人类健康的环境毒物和已知的人类致癌物。砷化氢为无色、有大蒜样臭味的剧毒物质，是一种在工业生产过程中产生的废气，多见于冶金工业。砷化氢是强烈的溶血性毒物，短时间内吸入高浓度的砷化氢可随血液循环分布至全身各脏器，临床上常出现以急性血管内溶血及急性肾功能损害为主的各种临床表现，重者引起多器官功能衰竭（MOF），病死率高达 20%～30%。 我院于 2013～2014年共收治70 例中毒患者，现将行血液透析联合血液灌流治疗的护理介绍如下。 1.资料与方法 1.1一般资料 70例患者均有明确的工业废气接触史，其中男55例，女15