重度ARDS患者持续床旁血液滤过同时行俯卧位通气的护理

Nursing of continuous beside hemofiltration and prone position ventilation on serious ARDS patients

目的:总结26例重度ARDS患者持续床旁血液滤过同时行俯卧位通气的实施方法和护理措施,为ICU护士在持续床旁血液滤过同时行俯卧位通气提供理论及实践支持。方法:选取我科2014年10月~2016年12月ARDS患者26例,对患者实施持续床旁血液滤过同时行俯卧位通气的护理过程及方法进行观察总结。结果:通过对ARDS患者采取持续床旁血液滤过同时行俯卧位通气治疗护理,患者无意外和护理操作并发症发生,有效改善了患者的氧合和预后,26例患者中有24例病情平稳后转至普通病房,2例因多脏器功能衰竭、脓毒症休克死亡。结论:对持续床旁血液滤过同时行俯卧位通气的患者,为保证患者的安全,除了掌握一种既简便又省时、省力的俯卧位通气操作流程外最重要的是做好风险因素的评估和充分的准备工作,做到预防为主;为临床提供有效的治疗方案。

Obsjective： To summarize implementation method and nursing intervention on 26 cases of serious ARDS patients with the help of continuous beside hemofiltration and prone position ventilation,and provide theory and practice for ICU nurses in continuous beside hemofiltration and prone position ventilation. Methods： To select 26 cases of serious ARDS patients in our department from Oct. 2014 to Dec. 2016,and observe and summarize the nursing process and methods of continuous beside hemofiltration and prone position ventilation on patients. Results： It was founded that it can efficiently improve patient＇s oxygenation and prognosis after the continuous beside hemofiltration and prone position ventilation on patients without any accidents and nursing procedure complications,24 patients of 26 cases were transferred to ordinary ward when they were in a stable condition,2 patients were shock and dead for multiple organs failure and sepsis. Conclusion： For the patients with continuous beside hemofiltration and prone position ventilation,to protect the patients,it was necessary to master an easy,timesaving,and labor-saving prone position ventilation operation procedures,what＇s more,ensure risk factors assessments and full prepared work,and remember prevention first. It had provided effective therapeutic scheme for clinic.