连续性血液净化技术在糖尿病乳酸酸中毒患者中的应用及护理

Application and nursing of continuous blood purification in diabetes patients with lactic acidosis

目的：探讨连续性血液净化技术（ CRRT）在糖尿病乳酸酸中毒患者中的应用及护理措施。方法选取2008年6月-2012年5月行CRRT抢救的重症糖尿病乳酸酸中毒患者12例，收集患者首次CRRT前后血生化、全血乳酸及血pH值的变化情况，统计患者的病死率及并发症。结果12例患者共抢救成功9例，死亡3例，病死率为25％。治疗后血pH值、HCO3-接近正常，血乳酸、血肌酐显著下降。结论积极有效的护理能够保证CRRT的顺利进行，改善患者的预后，减少并发症的发生，显著提高抢救成功率，达到满意的治疗效果。

Objective To explore the application and nursing measures of continuous blood purification /continuous renal replacement therapy （CRRT） in diabetes patients with lactic acidosis .Methods Twelve severe diabetes patients with lactic acidosis from June 2008 to May 2012 were chosen and received the rescue of CRRT in our hospital .The changes of blood biochemistry , blood lactate and blood pH were observed before and after first CRRT.Results The cases of patients who were successfully rescued were 9 cases, and the cases of death patients were 3 cases （25%）.The levels of blood pH and HCO3-keeps close to normal, and the levels of blood lactate and creatinine were significantly decreased after the treatment .Conclusions The active and effective nursing can ensure the smooth progress of the CRRT , improve the patients ’ prognosis , reduce the incidence of complications , and significantly improve the success rate of rescue in order to achieve the satisfactory therapeutic effect.