Evaluation of the application of Chinese medicine cluster nursing in the treatment of CRRT of ICU patients
杨小岚 1张娟 1李波 1刘萍 1王春娟 1李宛谕 1谢敏2
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作者信息
1. 南充市中医医院重症医学科,四川南充 637000
2. 西南医科大学附属中医院重症医学科,四川泸州 646000
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摘要
目的:评价中医集束化护理在ICU重症患者连续肾脏替代疗法(continuous renal replacement therapy,CRRT)治疗中的应用效果.方法:选取2021年7月～2023年2月在我院进行CRRT治疗的151例重症患者,按照护理方案不同分为对照组(n=75,常规护理)和观察组(n=76,中医集束化护理).对比两组临床指标、炎性指标[C反应蛋白(C-reactive protein,CRP)、血肌酐(Serum Creatinine,Scr)、尿素氮(Blood Urea Nitrogen,BUN)]、急性生理与慢性健康评分 Ⅱ(Acute Physiology and Chronic Health Evaluation Ⅱ,APACHE Ⅱ)、多器官功能障碍综合征(mul-tiple organ dysfunction score,MODS)评分表、营养状态及并发症发生情况.结果:观察组CRRT使用时间、管路使用时间及入住ICU时间均显著短于对照组(P＜0.05).护理后两组CRP、SCr、BUN水平均降低,且观察组比对照组低(P＜0.05).护理后两组APACHE Ⅱ、MODS评分均降低,且观察组比对照组低(P＜0.05).护理后两组血红蛋白、前白蛋白及总白蛋白水平均升高,且观察组比对照组高(P＜0.05).护理后观察组并发症总发生率(7.89％)比对照组低(24.00％)(P＜0.05).结论:在ICU重症患者CRRT治疗中实施中医集束化护理,可有效改善患者临床指标、炎性因子水平,同时降低并发症发生情况.
Abstract
Objective To evaluate the application effects of TCM cluster nursing in ICU patients with continuous renal re-placement therapy(CRRT).Methods 151severely ill patients who received CRRT treatment in our hospital from July 2021to Feb-ruary 2023were selected,and were divided into control group of 75cases(routine nursing)and observation group of 76cases ac-cording to different nursing plans.The clinical index,inflammatory index[C-reactive protein(CRP),Serum Creatinine(Scr),Blood Urea Nitrogen(BUN),Acute Physiology and Chronic Health Evaluation Ⅱ(APACHE Ⅱ),multiple organ dys-function score(MODS),Vegetative state and complications were compared in the two groups.Results The use time of CRRT,tube use time and ICU stay time in observation group were significantly shorter than those in control group(P＜0.05).After nurs-ing,the levels of CRP,SCr and BUN were decreased in the two groups,and the observation group was lower than the control group(P＜0.05).After nursing,APACHE Ⅱ and MODS scores of the two groups were decreased,and the observation group was lower than the control group(P＜0.05).After nursing,the levels of hemoglobin,prealbumin and total albumin in the two groups were increased,and the observation group was higher than the control group(P＜0.05).The total complication rate of the obser-vation group(7.89％)was lower than that of the control group(24.00％)(P＜0.05).Conclusions The application of Chinese medicine cluster nursing in ICU patients with CRRT treatment can effectively improve the level of clinical indicators,inflammatory factors,and reduce the incidence of complications.
关键词
集束化护理/连续肾脏替代疗法/重症/炎性指标
Key words
Cluster nursing/Continuous renal replacement therapy/Severe case/Inflammatory index
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