连续性静脉-静脉血液滤过治疗多器官功能障碍综合征的护理

CLINICAL OBSERVATION OF CONTINUOUS VENO-VENOUS HEMOFILTRATION TREATING MULTIPLE ORGAN DYSFUNCTION SYNDROME AND ITS NURSING

目的研究连续性静脉-静脉血液滤过(CVVH)对多器官功能障碍综合征(MODS)病人的疗效及护理。方法25例MODS病人行CVVH治疗,观察治疗前后生命体征,血尿素氮、肌酐、动脉血氧分压及氧合指数的变化,电解质、酸碱平衡变化。结果与治疗前相比较,患者心率、呼吸频率显著下降(p<0.05),平均动脉压明显升高(p<0.05),血尿素氮、肌酐显著下降(p<0.05),动脉血氧分压、氧合指数明显升高(p<0.05)。高钾血症、酸中毒得到纠正(p<0.05),Na+、Ca2+、Cl-虽有下降趋势,但无统计学差异(p>0.05)。结论CVVH能有效缓解MODS病人的临床症状,改善病人脏器功能,纠正电解质紊乱、酸碱失衡,适当护理,能有效提高MODS抢救成功率。

Objective Research on the efficacy of continuous veno - venous hemofihration （CVVH） for multiple organ dysfunction syndrome （MODS） and patient care. Methods Evaluated the changes of vital sign, blood urea nitrogen, creatinine, arterial partial pressure of oxygen, oxygenation index, electrolytes and acid -base balance of 25 patients with MODS before and after CWH. Results After CWH, significant decreases were found in heart rate, breathing frequency, blood urea nitrogen and creatinine（ after vs. before CVVH, p 〈 0. 05 ） ; significant increases were found in mean arterial blood pressure, arterial partial pressure of oxygen and oxygenation index（ after vs. before CWH, p 〈 0.05 ） ; hyperkalemia and acidosis were alleviated （ after vs. before CVVH, p 〈 0. 05 ） ; the serum so- dium, calcium and chlorum decreased after CVVH, but the difference was not statistically significant （p 〉 0. 05 ）. Conclusion CVVH can effectively alleviate the MODS patients with clinical symptoms, patients＇ organ function should be improved, electrolyte disorders, acid - base imbalance be corrected, and proper care can effectively enhance survival rate of MODS.