危重患者床边血液透析治疗的护理

Nursing Care of Critically Ill Patients Undergoing Bedside Hemodialysis

目的:观察危重患者床边血液透析治疗的护理。方法:选取笔者所在医院2017年1月-2019年1月收治的危重患者采取床边血液透析治疗138例,按随机数字法将其分为对照组(69例)与试验组(69例)。对照组患者采取常规护理干预,而试验组患者采取综合性护理干预。比较两组患者血液透析前、后尿素氮、肌酐水平,比较两组APECHEⅡ评分、床旁透析时长及透析过程中不良事件发生率。结果:血液透析后试验组患者肾功能肌酐、尿素氮水平均明显低于对照组,差异有统计学意义(P<0.001)。血液透析后两组APECHEⅡ评分均明显降低,且试验组APECHEⅡ评分明显低于对照组,差异有统计学意义(P<0.001)。试验组患者床旁透析时长明显短于对照组,差异有统计学意义(P<0.001)。试验组患者在透析过程中不良事件发生率为2.90%,对照组为15.94%,两组比较差异有统计学意义(P<0.01)。结论:在危重患者床边血液透析中,采取综合性护理干预,可维持体内酸碱平衡,缩短透析时长,改善患者预后,减少透析过程中不良事件的发生,效果理想。

Objective:To observe the nursing of bedside hemodialysis for critically ill patients.Method:A total of 138 critically ill patients were treated by bedside hemodialysis in our hospital from January 2017 to January 2019 were selected.They were divided into control group(69 cases) and experimental group(69 cases) according to random number method.The patients in the control group received routine nursing intervention,while the experimental group received comprehensive nursing intervention.The levels of urea nitrogen and creatinine before and after hemodialysis were compared between the two groups.APECHE Ⅱscore,length of bedside dialysis and incidence of adverse events during hemodialysis were compared between the two groups.Result:After hemodialysis,the levels of creatinine and urea nitrogen in the experimental group were significantly lower than those in the control group,the differences were statistically significant(P<0.001).After hemodialysis,APECHE Ⅱ scores in the two groups were significantly lower,and APECHE Ⅱ scores in the experimental group was significantly lower than that in the control group,the differences were statistically significant(P<0.001).The duration of bedside dialysis in the experimental group was significantly shorter than that in the control group,the difference was statistically significant(P<0.001).The incidence of adverse events during dialysis in the experimental group was 2.90%,while that in the control group was 15.94%.There was significant difference between the two groups(P<0.01).Conclusion:In bedside hemodialysis of critically ill patients,comprehensive nursing intervention can maintain acid-base balance,shorten the duration of dialysis,improve the prognosis of patients,and reduce the occurrence of adverse events during dialysis.