心脏手术后体外膜氧合并联连续性肾脏替代治疗的连接方法及对护理工作的影响

Nursing care of common connection modes of extracorporeal membrane oxygenation combined with continuous renal replacement therapy after cardiac surgery

目的 总结体外膜氧合(ECMO)并联连续性肾脏替代治疗(CRRT)的常用连接方式及护理要点。方法 选择本院2017年至2020年进行ECMO并联CRRT辅助治疗的患者17例,对ECMO辅助期间进行CRRT压力监测并对不同的连接方式的动脉压、静脉压和跨膜压差,以及滤器使用时间等数据进行分析,并对相应模式下ECMO并联CRRT的护理进行总结。结果 在ECMO并联CRRT辅助治疗期间,其桥接的连接方式各项压力均优于其他连接方式(P<0.01),治疗过程顺利。在滤器使用时间上,桥接法也优于泵后-膜后和泵后-膜前的连接方法(P<0.01)。结论 桥接方式对CRRT并联ECMO辅助治疗过程中CRRT压力影响最小,目前是对患者和护理工作的最优连接方式。

Objective To summarize the common connection modes and nursing points of continuous renal replacement therapy(CRRT) combined with extracorporeal membrane oxygenation(ECMO).Methods A total of 17 patients who received CRRT combined with ECMO from 2017 to 2020 were selected.The CRRT pressure was monitored during ECMO,and the data of arterial pressure,venous pressure,transmembrane pressure difference,and filter usage time of different connection modes were analyzed,and the nursing of CRRT and ECMO in the corresponding mode was summarized.Results During the CRRT and ECMO treatment,the pressure of the bridging connection was superior than that of other connections(P<0.01),and the treatment process was smooth.In terms of filter service time,the bridging method was also better than the pump-post-membrane method and the pump-pre-membrane method(P<0.01).Conclusion Bridging mode has the least impact on CRRT pressure in therapy,which is currently the optimal connection mode for patients and nursing work.