ICU重症CRRT患者非计划下机发生的影响因素

Influencing factors of unplanned withdrawing machine in patients with severe CRRT in ICU

目的观察重症监护治疗病房(ICU)重症连续性肾脏替代治疗(CRRT)患者非计划下机发生的影响因素。方法回顾性分析医院2017年1月至2020年1月收治的80例CRRT患者的临床资料,收集基线资料。根据非计划下机发生情况将患者分为非计划下机组和计划下机组,经logistic回归分析检验患者非计划下机发生的影响因素。结果80例CRRT患者中,有35例(43.75%)为非计划下机,有45例(56.25%)为计划下机。非计划下机组血流速度低于计划下机组,静脉壶栓塞容积比、血细胞比容、治疗剂量、凝血酶原活动度(PTA)高于计划下机组,差异有统计学意义(P<0.05)。logistic回归分析显示,血流速度慢、静脉壶栓塞容积比高、血细胞比容高、治疗剂量大、PTA高是ICU重症CRRT患者发生非计划下机的危险因素(OR>1,P<0.05)。结论ICU重症CRRT患者非计划下机发生风险高,与非计划下机发生相关的风险因子包括血流速度慢、静脉壶栓塞容积比高、血细胞比容高、治疗剂量大、PTA高。

Objective To observe the influencing factors of unplanned withdrawing of patients with continuous renal replacement therapy(CRRT)in the intensive care unit(ICU).Methods The clinical data of 80 CRRT patients admitted to the hospital from January 2017 to January 2020 were retrospectively analyzed,and baseline data were collected.According to the occurrence of unplanned withdrawing,patients were divided into unplanned and planned withdrawing units,and logistic regression analysis was used to test the influencing factors of unplanned disengagement.Results Among 80 CRRT patients,a total of 35 cases(43.75%)were unplanned withdrawing,and another 45 cases(56.25%)were planned withdrawing.The blood flow rate of the unplanned withdrawing unit was lower than that of the planned withdrawing unit,and the volume ratio of venous ampulla embolism,hematocrit,therapeutic dose,and prothrombin time activity(PTA)were higher than those of the planned unit,and the differences were statistically significant(P<0.05).Logistic regression analysis showed that slow blood flow,high volume ratio of venous ampulla embolism,high hematocrit,high therapeutic dose,and high PTA were the risk factors for unplanned withdrawing of ICU patients with severe CRRT(OR>1,P<0.05).Conclusion The risk of unplanned withdrawing machine in patients with severe CRRT in ICU is high,the risk factors of unplanned withdrawing machine include slow velocity of blood flow,high volume ratio of jugular embolization,high packet cell volume,high therapeutic dose and high PTA.