床边持续静-静脉血液滤过抢救ICU重度高血钾的有效性及对患者生命体征的影响

Efficacy of Bedside Continuous Intravenous-venous Hemofiltration in Rescuing Patients with Severe Hyperkalemia in ICU and Its Effect on Patients’ Vital Signs

目的:探讨床边持续静-静脉血液滤过(CVVH)抢救ICU重度高血钾的有效性及对患者生命体征的影响。方法:选取2016年2月-2020年2月在本院确诊并治疗的45例ICU重度高血钾患者,依据不同治疗方式分为对照组(n=22)和研究组(n=23)。对照组应用常规综合治疗,研究组应用CVVH治疗。比较两组的治疗效果和治疗前后的相关生命体征指标(心率、呼吸)、相关实验室指标[肌酐(Cr)、血尿素氮(BUN)]和血钾水平。结果:研究组有效率高于对照组,差异有统计学意义(P<0.05);治疗后,研究组的心率、呼吸水平均低于对照组,差异均有统计学意义(P<0.05);治疗后,两组的Cr、BUN水平均低于治疗前,且研究组上述指标水平均低于对照组,差异均有统计学意义(P<0.05);治疗后2、6、12 h,研究组的血钾水平均低于对照组,差异均有统计学意义(P<0.05)。结论:给予ICU重度高血钾患者使用CVVH治疗,可显著提高有效率,降低患者的血钾水平,使得相关生命体征指标及实验室指标更好地恢复正常。

Objective:To investigate the effectiveness of bedside continuous intravenous-venous hemofiltration (CVVH) in rescuing patients with severe hyperkalemia in ICU and its effect on patients’ vital signs.Method:A total of 45 patients with severe hyperkalemia in ICU diagnosed and treated in our hospital from February 2016 to February 2020 were selected,they were divided into control group (n=22) and study group (n=23) according to different treatment methods.The control group was treated with conventional comprehensive treatment,and the study group was treated with CVVH.The effects of treatment,the relevant vital signs (heart rate,respiration),relevant laboratory indicators[creatinine (Cr),blood urea nitrogen (BUN)]and serum potassium levels before and after treatment were compared between the two groups.Result:The effective rate of the study group was higher than that of the control group,the difference was statistically significant (P<0.05);after treatment,the heart rate and respiratory level of the study group were lower than those of the control group,the differences were statistically significant (P<0.05);after treatment,the levels of Cr and BUN in two groups were lower than those before treatment,and the above indexes in study group were lower than those of control group,the differences were statistically significant (P<0.05);2,6,12 h after treatment,the serum potassium levels in the study group were lower than those in the control group,the differences were statistically significant (P<0.05).Conclusion:The use of CVVH in ICU patients with severe hyperkalemia can significantly improve the effective rate,reduce the serum potassium level of patients,and make the related vital signs and laboratory indicators better return to normal.