高容量血液滤过治疗重症急性胰腺炎的观察和护理.docVIP

精品论文 参考文献 高容量血液滤过治疗重症急性胰腺炎的观察和护理 王红梅 　　成都军区总医院肾内科四川成都610083 　　作者简介：王红梅（1970-），女，主管护师，护士长，主要从事血液净化的护理研究。【摘要】目的：探讨高容量血液滤过（HVHF）治疗重症急性胰腺炎（SAP）的疗效和护理方法。方法：回顾性分析成都军区总医院自2006年以来行HVHF治疗的45例SAP的患者，按治疗转归分死亡组和存活组，对比分析两组HVHF治疗前和治疗24h的APACHE Ⅱ评分、SOFA评分、氧合指数、血尿素氮（BUN）、血浆肌酐（Cr）、平均动脉压（MAP）。HVHF治疗中严密观察患者的生命体征及机器各项参数。结果：本组45例重症急性胰腺炎患者中死亡率达到了467%。经HVHF治疗24h之后，死亡组的SOFA评分和APACHE Ⅱ评分没有出现明显的变化，而存活组则出现较为明显地降低；与存活组相比，存活组在HVHF治疗24h后和治疗前的SOFA评分和APACHE Ⅱ评分明显要高一些。在HVHF治疗24h后，两组的MAP、Cr、BUN、氧合指数都得到了较为明显的改善。结论：SAP的预后能够通过早期HVHF来进行改善，HVHF也能够对SAP进行有效辅助治疗；SOFA评分和APACHE Ⅱ评分能够有利于指导判断预后情况；要保证HVHF的顺利、安全进行，必须要采取恰当的护理。 　　【关键词】高容量血液滤过；重症急性胰腺炎；APACHE Ⅱ评分；护理Observation and nursing of high volume hemofiltration on severe acute pancreatitis 　　Wang Hongmei 　　【Abstract】Objective:To investigate the effect of high volume hemofiltration(HVHF)in treatment of severe acute pancreatitis(SAP)curative effect and nursing methods. Methods:a retrospective analysis of 45 cases of SAP patients in General Hospital of Chengdu Military Region since 2006 for HVHF treatment, the treatment outcome is divided into death group and survival group, comparative analysis of two groups of HVHF before treatment and 24h APACHE score, SOFA score, oxygenation index, blood urea nitrogen(BUN), serum creatinine(Cr), mean arterial pressure(MAP). Vital signs and machine parameters of HVHF in the treatment of close observation of patients. Results:in this group, 45 cases of severe acute pancreatitis mortality reached 46 7%. After treatment with HVHF 24h, the death group SOFA score and APACHE Ⅱ score did not show significant changes, while the survival group is obviously reduced; compared with the survival group, the survival group at HVHF after 24h treatment and before treatment, SOFA score and APACHE Ⅱ score significantly higher. In HVHF after 24h treatment, two groups of MAP, Cr, BUN, oxygenation index have been improved obviously. Conclusion:the prognosis of SAP by early HVHF to make improvements, HVHF can also be effective adjuvant therapy fo