连续性肾脏替代治疗在抢救急危重患者中护理体会.docVIP

连续性肾脏替代治疗在抢救急危重患者中护理体会 　　【摘要】目的：探讨连续性肾脏替代治疗抢救急危重患者中的临床疗效及护理体会。方法 ：选取我院收治的62例临床急危重患者，给予连续性静-静脉血液滤过方式治疗，观察治疗前后患者血清尿素氮(BUN)、肌酐(Scr)、血清电解质钾、钠以及二氧化碳结合力的变化情况，并总结护理方法。结果 ：经过治疗和护理后， 29例治愈，18例好转，15例死亡，治疗后患者的BUN和Scr水平明显下降，K+和Na+的水平也明显下降，明显低于治疗前，而治疗后CO2CP明显高于治疗后，两组对比差异均具有统计学意义（P0.05）。结论 ：连续性肾脏替代治疗在抢救急危重患者时对血流动力学影响小，并可有效清除各种毒素以及炎性介质，同时给予有效的护理措施可改善患者的预后。 　　【关键词】连续性肾脏替代治疗；肾替代疗法；护理. 　　 Continuous renal replacement therapy in rescuing nursing in critically ill patients 　　【Abstract】Objective To explore the clinical curative effect and nursing experience of continuous renal replacement therapy rescue acute critically ill patients.Methods selected our hospital received 62 cases clinical acute critically ill patients, gave continuity of static - vein hemofiltration treatment, observed patients before and after treatment the change of BUN、Scr、serum potassium, sodium, and carbon dioxide binding force of the electrolyte, and summarize the nursing methods. Results After treatment and nuring, 29 cases were cured, 18 cases got better, 15 cases died, after treatment the patients level of BUN and Scr declined obviously, and the level of K+ and Na+ also declined obviously, were significantly lower than before treatment, and CO2CP after treatment were significantly higher than after treatment, compared the two groups were statistically significant difference (P 0.05).Conclusion continuous renal replacement therapy critically ill patients influence on hemodynamic is small, and can effectively remove toxins and inflammatory mediators, and give effective nursing intervention can improve the prognosis of patients. 　　【Key Words】Continuous renal replacement therapy; Renal replacement therapy;Nuring. 　　【中图分类号】R473??5【文献标识码】A 【文章编号】2095-6851（2014）06连续性肾脏替代治疗(CRRT)是指长时间替代受损肾脏功能的体外血液净化治疗方法，随着CRRT技术逐渐完善成熟，目前CRRT已不局限于肾脏替代治疗领域，已扩展到临床上各种常见危重病例的急救［1］。CRRT利用弥散、超滤以及渗透等原理连续排除过多水分，能够模拟尿的排泄方式，可以更好地维持血流动力学的稳定，具有血容量波动小、溶质清除率高以及清除细胞因子等特点［2］。为研究连续性肾脏替代治疗抢救急危重患者中的临床疗效及护理体会，我院选取收治的62例临床急危重患者，给予连续性静-静脉血液滤过方式治疗，现报道