杂合肾脏替代治疗顽固性心衰观察与护理

Observation and nursing about hybridrenal replacement in treatment of persistent heart failure

目的探讨杂合肾脏替代治疗(hybrid renal replacement therapy,HRRT)在顽固性心衰患者治疗中的临床疗效及护理方法。方法研究2015年3月—2017年1月在本院住院登记的33例顽固性心衰患者,观察其在行HRRT治疗后的病情及临床转归情况,总结其护理方法。结果 HRRT治疗后,体质量(用于评价病人液体潴留程度)下降(P<0.01),肿瘤坏死因子α(TNF-α)、白细胞介素6(IL-6)、白细胞介素8(IL-8)、C反应蛋白(C-reactive protein,CRP)、全血氨基末端B型脑钠肽前体(NT-proBNP)水平均下降(P<0.01),6 min步行试验(6MWT)、36条简明健康问卷(SF-36)得分提高(P<0.01),左心室射血分数(LVEF)明显升高(P<0.01)。结论 HRRT能清除液体潴留、清除炎症因子,改善心功能、提高运动耐力,可有效治疗顽固性心衰。

Objective To study the clinical curative effect and nursing methods about the hybrid renal replacement therapy（hybrid renal replacement therapy, HRRT）in the treatment of patients with refractory heart failure. Methods 33 patients with refractory heart failure hospitalized in our hospital from March 2015 to January 2017 were selected. Clinical outcomes and curative effects of all patients were observed after being treated with HRRT and the nursing methods were summarized. Results After treatment, the body mass, which was used to evaluate the degree of fluid retention, decreased（P〈 0.01）. Tumor necrosis factor alpha（TNF alpha）, interleukin 6（IL 6）and interleukin 8（IL 8）, c-reactive protein（C-reactive protein, CRP）and brain natriuretic peptide precursor of amino terminal b-type in whole blood（NT-proB NP）level all decreased（P〈 0.01）. 6-minutes-walk test（6 MWT）and 36 concise health questionnaire（SF-36）scores improved（P〈 0.01）. Left ventricular ejection fraction（LVEF）increased significantly（P〈 0.01）. Conclusion HRRT can remove fluid retention, remove inflammation factors, improve heart function and increase exercise endurance, so it can effectively cure refractory heart failure.