尿毒症合并心力衰竭患者应用CRRT的临床护理体会

目的 观察尿毒症合并心力衰竭患者应用CRRT（连续性肾脏代替疗法）的临床护理体会。方法本次选取我院2016年1月25日～2017年3月26日住院部收治的尿毒症合并心力衰竭患者40例；将其按照随机抽取的方式分为2组，观察组20例（护理干预），对照组20例（常规护理）；观察2组患者的收缩压、舒张压、心率、血肌酐、尿素氮、血钾、血HcO3、LVEDD、LVEF、BNP。结果观察组患者的收缩压（135.11±11.25mmHg）、舒张压（72.11±6.25mmHg）、心率（79.12±7.05次/min）低于对照组（P＜0.05）；观察组患者的血肌酐（356.11±170.12umol/L）、尿素氮（16.25±4.32mmol/L）、血钾（3.92±0.41mmol/L）、LVEDD（51.22±5.05mm）低于对照组（P＜0.05）；且观察组患者的血HcO3（21.65±7.36mmol/L）、LVEF（50.91±4.69%）、BNP（352.11±125.66pg/mL）与对照组对比，观察组明显优于对照组（P＜0.05）。结论CRRT治疗尿毒症合并心力衰竭效果显著，在治疗过程中对其进行护理干预，可以有效保障CRRT顺利进行，从而减少和预防并发症的出现，提高患者的存活率，临床上值得推广和应用。

Objective To observe the clinical nursing experience of CRRT(continuous renal replacement therapy)in patients with uremia complicated with heart failure.Methods Forty patients with uremia complicated with heart failure were enrolled in our hospital from January25,2016to March26,2017.The patients were divided into two groups according to the random sampling method.The observation group(20cases)(P<0.05).The systolic blood pressure,diastolic blood pressure,heart rate,serum creatinine,blood urea nitrogen,serum potassium,blood HcO3,LVEDD,LVEF and BNP were observed in the control group.Results The systolic blood pressure(135.11±11.25mmHg),diastolic blood pressure(72.11±6.25mmHg)and heart rate(79.12±7.05times/min)were lower in the observation group than in the control group(P<0.05)(31.25±4.32mmol/L),serum potassium(3.92±0.41mmol/L)and LVEDD(51.22±5.05mm)were lower than those in the control group(P<0.05),and the observation group The serum HcO3(21.65±7.36mmol/L),LVEF(50.91±4.69%)and BNP(352.11±125.66pg/mL)were significantly higher than those in the control group(P<0.05).Conclusion CRRT treatment of uremia complicated with heart failure is effective,and it can effectively protect CRRT during the treatment.It can reduce and prevent the occurrence of complications and improve the survival rate of patients.It is worthy to be popularized and applied clinically The