ARF患者CRRT治疗集束化护理管理研究

Effect of Clustering Nursing Combined With Risk Management on the Treatment of Acute Renal Failure With CRRT

目的探讨集束化护理联合风险管理模式的应用对急性肾功能衰竭(ARF)连续肾脏代替疗法(CRRT)患者治疗效果的影响。方法选取本院重症监护室2016年1月—2019年10月间44例接受CRRT治疗的ARF患者,随机分为对照组和观察组各22例。对照组患者给予CRRT常规护理,观察组在常规护理基础上应用集束化护理联合风险管理模式。治疗周期1个月,对比两组患者意外下机事件发生率、生存质量评分及血流动力学(动脉血氧分压PO2、动脉血二氧化碳分压PCO2、酸碱度)和肾功能指标(尿素氮BUN,血肌酐Scr)。结果观察组意外下机事件发生率明显低于对照组;治疗后,观察组生存质量各项指标评分均明显优于对照组,观察组PO2、酸碱度明显高于对照组,观察组PCO2、BUN、Scr明显低于对照组;差异均有统计学意义(P<0.05)。结论集束化护理联合风险管理模式的应用能显著改善ICU危重症合并ARF患者肾功能和血流动力学指标,优化治疗效果,提高生存质量。

Objective To investigate the effect of the combined risk management model of cluster therapy on the treatment outcome of patients with acute renal failure(ARF)continuous renal replacement therapy(CRRT).Methods Forty-eight patients with acute renal failure who underwent CRRT treatment from January 2016 to October 2019 in our intensive care unit were randomly divided into control group and observation group.Patients in the control group were given CRRT routine care,and the observation group applied clustered care combined risk management model on the basis of routine nursing.One month of treatment cycle,comparing the incidence of accidental downtime events,quality of life scores and hemodynamics(arterial oxygen partial pressure PO2,arterial blood carbon dioxide partial pressure PCO2,pH)and renal function indicators(urea nitrogen BUN),serum creatinine Scr).Results The incidence of accidental downtime in the observation group was significantly lower than that in the control group.The scores of the quality of life in the observation group were significantly better than those in the control group.The PO2 and pH of the observation group were significantly higher than those of the control group.The PCO2,BUN and Scr of the observation group were significantly lower than that of the control group.The control group;the difference was statistically significant(P<0.05).Conclusion The application of clustered nursing combined risk management model can significantly improve renal function and hemodynamic parameters in patients with ICU critically ill patients with ARF,optimize treatment effect and improve quality of life.