肾衰竭患者血透初期液体容量失衡的护理干预措施

Nursing intervention of liquid capacity imbalances of renal failure patients at the early stage of hemodialysis

目的探讨减少肾衰竭患者在血透初期出现液体容量失衡症状的护理干预措施。方法收集在本血液净化中心进行常规透析的慢性肾衰竭患者67例,并对血透初期出现液体容量失衡患者实施护理干预。结果血透初期出现失衡的37例肾衰竭患者中,超滤过多、低血压表现:头昏11例、耳鸣10例、呕吐和肌痉挛各9例、腰背痛和抽搐各6例;超滤不足、体液过多表现:高血压23例、嗜睡头昏7例、急性肺水肿7例、胸腹腔积液5例、心包积液4例。结论肾衰竭患者液体容量失衡的原因包括心理因素、移情因素、治疗因素、保护肾功能因素和饮食误区,采取相应的护理干预措施有助于患者安全度过血透初期,达到充分透析的效果。

Objective To explore nursing intervention in reducing liquid capacity imbal- ances of renal failure patients at the early stage of hemodialysis. Methods A total of 67 renal fail- ure patients with routine hemodialysis were collected in the research. And nursing intervention was applied in liquid capacity imbalances patients at the early stage of hemodialysis. Results There were 37 patients with liquid capacity imbalances. The patients with excessive ultrafiltration and hypotension were as follows. There were 11 cases with dizziness, 10 cases with tinnitus, 9 cases with vomiting and 9 cases with muscle cramps and 6 cases with backache and 6 cases with spasm. The clinical symptoms for inadequate ultrafiltration and excess liquid were hypertension in 23 cas- es, drowsiness in 7 cases, acute pulmonary edema in 7 cases, thoracic and abdominal effusion in 5 cases and pericardial effusion in 4 cases. Conclusion The main causes for liquid capacity imbal- ances include psychology, empathized factor, therapy factor, renal function protection and diet. Appropriate intervention can help patients pass early stage of hemodialysis safely and achieve ade- quate dialysis effect.