肾移植术后多尿期两种循环补液方式的对比研究

Effects of two methods of circulating fluid infusion in polyuric period after renal transplantation

目的比较肾移植术后多尿期两种循环补液方式对患者肾功能、血电解质、血糖水平的影响,探讨更加优化的循环补液方式。方法 2010年1月至2012年12月在我中心实施肾移植的132例患者按随机数字表法分成传统治疗组与改进治疗组。传统治疗组循环补液按顺序依次、单瓶、经输液泵输入,改进治疗组术后按循环补液表将所有液体混合配制成离子浓度和渗透压适宜移植肾功能恢复的3 L袋溶液,经输液泵输入,循环补充。观察两组患者术前及术后各时间点血肌酐(Cr)、尿素氮(Bun)、电解质、血糖浓度的变化,比较两组患者补液效果。结果两组患者术后各时间点肾功能、电解质比较差异均无统计学意义(P>0.05),血糖值在术后4、8、12、16、24、48、72 h差异均有统计学意义(P<0.05)。结论改进循环补液方式,可维持肾移植患者术后多尿期血电解质平衡,有效控制血糖水平;并能解决传统补液方式存在的液体种类多、操作相对繁琐等问题,有效提高护理工作质量与效率。

Objective To explore the circulating fluid efficacy of two different infusion ways in patients within the polyuric period after renal transplantation （RT）. Methods From Jan. 2010 to Dec. 2012, a total of 132 consecutive patients with chronic kidney failure who underwent RT in Division of Transplantation were randomly divided into traditional circulating fluid therapy group and improved therapy group, and the level of serum creatinine, urea nitrogen, electrolytes, as well as hlood glucose concentration were observed at different time. Results The kidney function and electrolytes between the groups had no significant difference. The level of blood glucose can be controlled more effectively and stably in polyuric RT patients using 3L bags of rehydration solution （P 〈 0. 05 ）. Conclusion Improvement of circulating fluid could be maintained blood electrolyte balance, effective control of blood glucose levels in patients with polyuria period after renal transplantation; and solve many problems such as the disadvantage of traditional circulating fluid therapy and relatively operaation cumbersome, then improve effectively the quality and efficiency of nursing work.