优质护理在重症监护病房行连续性肾脏替代治疗患者血流感染预防中的应用效果

Application efficacy of high-quality nursing on the prevention of bloodstream infections in patients undergoing continuous renal replacement therapy in the intensive care unit

目的探讨优质护理对急诊医学中心行连续性肾脏替代治疗(CRRT)患者血流感染的预防效果。方法选择福建医科大学附属第一医院急诊医学中心开展CRRT治疗患者75例,采用随机数表法分为常规组(37例)与研究组(38例)。常规组开展基础护理,研究组在此基础上增用优质护理。比较两组护理效果、CRRT相关并发症发生情况,治疗前后疾病严重程度、肾功能、营养指标、情绪状态及护理满意度。结果研究组管路使用时间、CRRT治疗时间长于常规组,重症监护病房(ICU)时间短于常规组,血流感染、静脉炎、导管堵塞、导管脱落、出血、严重电解质紊乱发生率低于常规组,差异有统计学意义(P<0.05);干预后研究组疾病严重程度评分低于常规组,血肌酐、尿素氮水平低于常规组,血清白蛋白、血红蛋白水平高于常规组,焦虑自评量表、抑郁自评量表评分低于常规组,护理满意度高于常规组,差异有统计学意义(P<0.05)。结论优质护理在ICU行CRRT治疗患者中应用可改善护理效果,减少血流感染等并发症发生率,有利于减轻疾病严重程度,改善患者肾功能、营养指标及情绪状态,患者护理满意度高。

Objective To investigate the efficacy of high-quality nursing on the prevention of bloodstream infections in patients undergoing continuous renal replacement therapy(CRRT)in the Emergency Medical Center.Methods A total of 75 patients undergoing CRRT treatment admitted to Emergency Medical Center of the First Affiliated Hospital of Fujian Medical University were selected.They were divided into the conventional group(n=37)and the study group(n=38)according to the random number table method.The conventional group was treated with basic nursing,while the study group was modified with additional high-quality nursing based on basic nursing.The nursing efficacy,CRRT-related complications,and disease severity,renal function,nutritional indices,emotional state and nursing satisfaction before and after treatment were compared between the two groups.Results In the study group,the use time of the pipeline and CRRT treatment time were longer than those in the conventional group,the intensive care unit(ICU)time was shorter than that in the conventional gr oup,and the incidences of bloods tream infections,phlebitis,catheter blockage,catheter shedding,hemorrhage and serious electrolyte disturbance were lower than those in the conventional group,with statistically significant differences(P<0.05).In the study group after intervention,the disease severity score was lower than that in the conventional group,the levels of serum creatinine and urea nitrogen were lower than those in the conventional group,the levels of serum albumin and hemoglobin were higher than those in the conventional group,self-rating anxiety scale and self-rating depression scale scores were lower than those in the conventional group,and the nursing satisfaction was higher than that in the conventional group,all with statistically significant differences(P<0.05).Conclusion The application of high-quality nursing in ICU patients undergoing CRRT treatment can improve the nursing efficacy,reduce the incidence of complications such as bloodstream infections,help to reduce the severity of the disease,and improve the patients’renal function,nutritional indices and emotional status.Therefore,the patients’nursing satisfaction is high.