基于护士的抗凝管理模式对肝素抗凝血液滤过患者效果的影响

Effect of nurse based anticoagulation management model on patients with heparin anticoagulation hemofiltration

目的探讨肝素抗凝血液滤过在护士的抗凝管理模式下对患者效果的临床研究。方法选取东莞市人民医院重症医学科2018年12月至2020年7月收治的住院并实施肝素抗凝血液滤过治疗患者200例。按照随机数字表法将患者分为研究组和常规组,每组各100例。研究组针对患者积极实施肝素抗凝血液滤过方式治疗,常规组均实施以医师为主导的抗凝方式干预。比较两组患者抗凝滤器使用寿命、尿素氮、凝血酶原时间、部分活化凝血酶原时间、血小板含量、红细胞悬液、血浆等。结果研究组抗凝滤器使用寿命为(41.11±7.20)h,明显高于常规组的(29.03±2.18)h,差异有统计学意义(P<0.05)。研究组的肌酐为(102.27±11.58)mg、尿素氮为(5.78±1.68)mmol/L,低于常规组的(138.20±12.77)mg和(7.89±1.67)mmol/L,差异有统计学意义(P<0.05)。干预后,研究组凝血酶原时间和部分活化凝血酶原时间分别为(8.2±2.3)s和(67.5±10.5)s,均短于常规组的(11.8±3.2)s和(82.6±12.5)s,差异有统计学意义(P<0.05),研究组血小板含量水平、红细胞悬液水平及血浆水平分别为(162.1±25.2)×10^(9)/L、(260.5±45.8)ml和(208.1±34.8)ml,均明显高于常规组,差异有统计学意义(P<0.05),研究组护士的护理观察、交流沟通、专业技术水平以及感染防护等临床护理能力得分分别为(9.23±0.11)、(8.45±1.21)、(9.43±0.45)、(8.67±1.01)分,均明显高于常规组护士,差异有统计学意义(P<0.05)。结论静脉血液滤过抗凝可以延长滤器寿命,并提高溶质清除,同时增加红细胞输注量,促进患者临床指标的改善以及身体康复,并且有效提高医护人员的工作能力,值得临床推广。

Objective To explore the clinical effect of heparin anticoagulant hemofiltration on patients under the anticoagulant management mode of nurses.Methods A total of 200 patients admitted to the Department of Critical Medicine,Dongguan People’s Hospital from December 2018 to July 2020 and receiving heparin anticoagulant hemfiltration therapy were selected.Patients were divided into study group and routine group according to random number table method,with 100 cases in each group.The study group actively implemented heparin anticoagulant hemofiltration treatment for patients,while the conventional group implemented physician-led anticoagulant intervention.Filter life,urea nitrogen,prothrombin time(PT),partially activated prothrombin time(APTT),platelet content,erythrocyte suspension and plasma levels were compared between the two groups.Results The service life of anticoagulant filter in study group was(41.11±7.20)h,which was significantly higher than that in routine group(29.03±2.18)h,with statistically significant difference(P<0.05).The creatinine and urea nitrogen in the study group were(102.27±11.58)mg and(5.78±1.68)mmol/L,which were lower than those in the control group(138.20±12.77)mg and(7.89±1.67)mmol/L,with statistically significant differences(P<0.05).The prothrombin time and partial activation prothrombin time of the study group were(8.2±2.3)s and(67.5±10.5)s,respectively,which were shorter than those of the control group([11.8±3.2]s and[82.6±12.5]s),with statistically significant differences(P<0.05).The levels of platelet content,erythrocyte suspension and plasma in the study group were(162.1±25.2)×10^(9)/L,(260.5±45.8)ml and(208.1±34.8)ml,respectively,which were significantly higher than those in the routine group,with statistically significant differences(P<0.05).The scores of nursing observation,communication,professional skill level and infection prevention in the study group were(9.23±0.11),(8.45±1.21),(9.43±0.45),(8.67±1.01),respectively,which were significantly higher than those in the conventional group,with statistically significant differences(P<0.05).Conclusion Intravenous hemofiltration anticoagulation can prolong the filter life,improve solute clearance,increase red blood cell transfusion volume,promote the improvement of patients’clinical indicators and physical rehabilitation,and effectively improve the work ability of medical staff,which is worthy of clinical promotion.