危重症患者在连续肾脏替代疗法治疗中实施针对性护理对提升血管通畅率的作用研究

Research on the Effect of Targeted Nursing in Continuous Renal Replacement Therapy on Improving Vascular Patency Rate in Critically Ill Patients

目的:探讨危重症患者在连续肾脏替代疗法(CRRT)治疗中实施针对性护理对提升血管通畅率的应用效果。方法:选取2018年10月—2020年10月开封市人民医院收治的80例进行CRRT治疗的危重症患者作为研究对象,依据随机数表法分为对照组和实验组,每组各40例。对照组采用常规护理,实验组采用针对性护理。经治疗24 h后,对比分析两组患者的各项体征,统计血管畅通率与24 h内抗凝效果,观察滤器使用情况以及并发症发生率。结果:经CRRT治疗和干预24 h后,实验组体温差值、呼吸差值及心率差值低于对照组,尿素氮差值和肌酐差值明显高于对照组,差异有统计学意义(t=142.836、82.700、69.710、11.627、7.098,P<0.05)。两组患者血管畅通率与24 h内抗凝有效率比较,实验组明显高于对照组,差异有统计学意义(χ^(2)=15.932、30.426,P<0.05)。两组患者滤器使用情况比较,实验组单个滤器使用时间与滤器总使用时间长于对照组,24 h滤器使用个数少于对照组,差异有统计学意义(t=8.657、6.275、7.729,P<0.05)。两组患者并发症发生率比较,实验组明显低于对照组,差异有统计学意义(χ^(2)=19.531,P<0.05)。结论:危重症患者在CRRT治疗中采用针对性护理效果理想,可有效改善危重症患者各项体征,促进血管畅通,增强凝血功能,优化滤器使用,降低并发症发生率。

Objective:To explore the application effect of targeted nursing in continuous renal replacement therapy(CRRT)treatment on improving vascular patency rate in critically ill patients.Methods:A total of 80 critically ill patients treated with CRRT who were admitted to the hospital from October 2018 to October 2020 were selected as the research objects, and divided into a control group and an experimental group according to the random number table method, with 40 cases in each group. The control group was given routine nursing care, while the experimental group was given specific nursing care. After 24 h of treatment,the signs of the two groups were compared and analyzed, the patency rate of blood vessels and the effect of anticoagulation within24 h were counted, and the use of filter and the rate of complications were observed.Results:After 24 h of CRRT treatment and intervention, the differences in body temperature, respiration and heart rate in the experimental group were lower than those in the control group, urea nitrogen difference and creatinine difference were significantly higher than those in the control group, and the differences were statistically significant(t=142.836, 82.700, 69.710, 11.627, 7.098, P<0.05). The vascular patency rate and the effective rate of anticoagulation within 24 h in the experimental group were significantly higher than those in the control group, and the differences were statistically significant(χ^(2)=15.932, 30.426, P<0.05). The use time of a single filter and the total use time of the filter in the experimental group were longer than those in the control group, and the number of filters used in 24 h was less than that in the control group, and the differences were statistically significant(t=8.657, 6.275, 7.729, P<0.05). The incidence of complications in the experimental group was significantly lower than that in the control group, and the difference was statistically significant(χ^(2)=19.531, P<0.05).Conclusion:Targeted nursing in critically ill patients has an ideal effect, which can effectively improve various signs of patients, promote vascular patency, enhance coagulation function, optimize the use of filters, and reduce the incidence of complications.