首页|体外循环改良式加温护理对局部枸橼酸抗凝连续性肾脏替代治疗肝癌患者的影响

体外循环改良式加温护理对局部枸橼酸抗凝连续性肾脏替代治疗肝癌患者的影响

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目的:探讨体外循环改良式加温护理对局部枸橼酸抗凝连续性肾脏替代治疗(continuous renal replacement therapy,CRRT)肝癌患者的影响。方法:选取 2021 年 2 月—2023 年 2 月电子科技大学医学院附属绵阳医院·绵阳市中心医院收治的 94 例局部枸橼酸抗凝CRRT肝癌患者。随机将其分为对照组和观察组,各 47 例。对照组给予常规体温护理,观察组在对照组基础上给予体外循环改良式加温护理。比较两组体温情况、血流动力学指标、溶血指标、枸橼酸蓄积情况、非计划下机情况。结果:观察组肛门、CRRT动脉端及静脉端上机最高与最低温度均高于对照组,差异有统计学意义(P<0。05)。观察组收缩压、舒张压、心率、呼吸频率差值均低于对照组,差异有统计学意义(P<0。05)。两组上机前、下机后红细胞(red blood cell,RBC)计数、游离血红蛋白(free hemoglobin,FHb)及间接胆红素(indirect bilirubin,IBIL)水平比较,差异无统计学意义(P>0。05)。观察组枸橼酸蓄积发生率低于对照组,差异有统计学意义(P<0。05)。观察组非计划下机率低于对照组,差异有统计学意义(P<0。05)。结论:行局部枸橼酸抗凝CRRT肝癌患者使用体外循环改良式加温护理可有效降低患者在治疗期间的体温丢失,使患者血流动力指标处于较为平稳状态,降低患者枸橼酸蓄积发生率及非计划下机率。
Effect of Modified Extracorporeal Circulation Heating Nursing on Continuous Renal Replacement Treatment with Local Citric Acid Anticoagulation in Patients with Liver Cancer
Objective:To explore the effect of modified extracorporeal circulation heating nursing on continuous renal replacement treatment(CRRT)with local citric acid anticoagulation in patients with liver cancer.Method:A total of 94 patients with CRRT liver cancer treated with local citric acid anticoagulant in Mianyang Central Hospital,School of Medicine,University of Electronic Science and Technology of China from February 2021 to February 2023 were selected.They were randomly divided into the control group and the observation group,47 cases in each group.The control group was given routine body temperature nursing,and the observation group was given modified extracorporeal circulation heating nursing on the basis of the control group.The temperature condition,hemodynamic index,hemolysis index,citric acid accumulation condition and unplanned shutdown situation of the two groups were compared.Result:The boarding the computer highest and lowest temperature of anus and CRRT arterial end,venous end in the observation group were higher than those in the control group,and the difference was statistically significant(P<0.05).The differences of systolic blood pressure,diastolic blood pressure,heart rate and respiratory rate in the observation group were lower than those in the control group,and the differences were statistically significant(P<0.05).There were no significant differences in the red blood cell(RBC)count,free hemoglobin(FHb)and indirect bilirubin(IBIL)levels between two groups before and after boarding plane(P>0.05).The incidence of citric acid accumulation in the observation group was lower than that in the control group,and the difference was statistically significant(P<0.05).The unplanned shutdown rate in the observation group was lower than that in the control group,and the difference was statistically significant(P<0.05).Conclusion:In patients with CRRT liver cancer treated with local citric acid anticoagulation,the use of improved extracorporeal circulation heating nursing can effectively reduce the body temperature loss of patients during treatment,keep the hemodynamic index of patients in a relatively stable state,and reduce the incidence of citric acid accumulation and the unplanned shutdown of patients.

Continuous renal replacement therapyLocal citric acid anticoagulationExtracorporeal circulation heatingHemodynamics

焦红、戴述洋、向静、杨凌

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电子科技大学医学院附属绵阳医院·绵阳市中心医院 四川 绵阳 621000

连续性肾脏替代治疗 局部枸橼酸抗凝 体外循环加温 血流动力学

四川天府老龄产业发展研究中心课题项目

TFLLCY2314

2024

中外医学研究
中国医院管理杂志社

中外医学研究

影响因子:1.149
ISSN:1674-6805
年,卷(期):2024.22(18)