无肝素盐水冲洗法在连续性血液净化中应用与护理

Application and nursing of non-heparin saline flushing method in continuous blood purification

目的探讨无肝素盐水冲洗法在连续性血液净化中如何使滤器寿命延长,从而达到最佳疗效。方法选取入住ICU患者40例,行无肝素盐水冲洗法连续性血液净化治疗40次,分Ⅰ组与Ⅱ组,各20次,当跨膜压达到300 mmHg时,Ⅰ组继续30 min以125 mL生理盐水冲洗,Ⅱ组通过采取增加血流速、停止生理盐水冲洗、减少脱水量、减少置换液量的方法,观察跨膜压变化及滤器凝血程度。结果Ⅱ组比Ⅰ组跨膜压下降(40±20)mmHg,滤器寿命延长(6±2)h。结论无肝素抗凝时,护士通过及时采取增加血流速、停生理盐水冲洗、减少脱水量、减少置换液量的方法能有效降低跨膜压,有效延长滤器寿命。

Objective To discuss how non-heparin saline flushing method can extend the life of filter and achieve the best effect in continuous blood purification.Methods Forty ICU patients used non-heparin saline flushing method in continuous blood purification therapy 40 times.They were divided into group Ⅰ and group Ⅱ.Each group used 20 times.When the transmembrane pressure reached 300mmHg,group Ⅰ used 125 mL saline flushing every 30 min utes,and group Ⅱtook measures that increased blood flow rate,stopped saline flushing,reduced fluid loss rate and reduced substitution to observe changes in transmembrane pressure and clotting of the filter.Results The transmembrane pressure dropped（40±20） mmHg and the life of filter extended（6±2） h when GroupⅡ was compared to group Ⅰ.Conclusion The nurse can use the method that increases blood flow rate,stop saline flushing,reduce fluid loss rate and reduce substitution which can reduce the transmembrane pressure and extend the life of filter effectively.