急性肾损伤病人连续性肾脏替代治疗期低血压发生危险因素及预防护理研究

Study on risk factors and preventive nursing of hypotension in patients with acute kidney injury during continuous renal replacement therapy

目的:探究急性肾损伤病人连续性肾脏替代治疗(CRRT)期间低血压发生的危险因素及预防护理措施。方法:选择医院2020年1月—2021年9月收治的急性肾损伤CRRT治疗病人100例,统计治疗期出现低血压的病人例数,通过回顾分析法获取病人临床资料,采用单因素分析、多因素Logistic回归分析筛选急性肾损伤病人CRRT治疗期低血压发生的独立危险因素,并据此制订预防护理措施。结果:统计结果显示,CRRT治疗期发生低血压病人共36例,发生率为36.00%;单因素分析得到,年龄、合并糖尿病、超滤量、SOFA评分、引血方式、治疗前使用缩血管药、血红蛋白、血清白蛋白为急性肾损伤病人CRRT治疗期低血压发生的危险因素(P<0.05);多因素Logistic回归分析得到,年龄≥60岁、合并糖尿病、超滤量≥100 mL/h、治疗前使用缩血管药、血红蛋白<100 g/L、血清白蛋白<40 g/L为急性肾损伤病人CRRT治疗期低血压发生的独立危险因素(P<0.01)。结论:急性肾损伤病人CRRT治疗期存在低血压风险,且其危险因素复杂,临床应加强病人低血压风险识别,并积极采取预防护理措施。

Objective:To explore the risk factors and preventive nursing measures of hypotension in patients with acute kidney injury during continuous renal replacement therapy(CRRT).Methods:A total of 100 patients with acute kidney injury treated with CRRT from January 2020 to September 2021 were selected.The patients with hypotension during the treatment period were counted,and the clinical data of the patients were obtained by retrospective analysis.Univariate analysis and multivariate Logistic regression analysis were used to screen the independent risk factors for hypotension in patients with acute kidney injury during CRRT,and based on which preventive nursing measures were formulated.Results:Statistical results showed that 36 cases of hypotension occurred during CRRT,with an incidence of 36.00%.Univariate analysis showed that age,diabetes mellitus,ultrafiltration,SOFA score,blood induction method,the use of vasoconstrictor before treatment,hemoglobin and serum albumin were the risk factors for hypotension in patients with acute kidney injury during CRRT(P<0.05).Multivariate Logistic regression analysis showed that age≥60 years,diabetes mellitus,ultrafiltration≥100 mL/h,use of vasoconstrictor before treatment,hemoglobin<100 g/L,serum albumin<40 g/L were independent risk factors for hypotension in acute kidney injury patients during CRRT(P<0.01).Conclusion:Patients with acute kidney injury are at risk of hypotension during CRRT treatment,and their risk factors are complex.Therefore,clinical identification of hypotension risk should be strengthened and preventive nursing measures should be actively taken.