不同温度液体冲洗管路及回血对无肝素血液透析患者的影响

Effect of liquid flushing lines in different temperatures and blood return in heparin-free hemodialysis patients

目的探讨使用不同温度液体冲洗管路及回血对无肝素血液透析患者的影响。方法选取100例无肝素血液透析患者(共300例次)作为研究对象,根据随机数字表法将300例次患者分为常规组和试验组,每组150例次。常规组使用室温生理盐水冲洗管路及回血,试验组使用加热至37℃的生理盐水(提前将生理盐水于37℃恒温箱中静置备用)冲洗管路及回血,比较2组液体温度、液体冲洗管路次数、透析器及血液管路凝血情况和残余血量、护理舒适度、身体不适情况和护理满意度。结果试验组冲洗管路液体温度、回血前液体温度、回血结束后静脉壶内液体温度均高于常规组,差异有统计学意义(P<0.05);试验组冲洗管路次数少于常规组,透析器及血液管路凝血情况和残余血量少于常规组,差异有统计学意义(P<0.05);试验组患者均未发生上肢低温、身体寒冷情况,护理舒适度、护理满意度高于常规组,差异有统计学意义(P<0.05)。结论使用加热至适宜温度(37℃)的生理盐水冲洗管路及回血,能够有效提升无肝素血液透析患者舒适度,减少上肢低温、身体寒冷等情况发生,并能改善管路凝血情况,减少冲洗管路次数和残余血量,提升患者护理满意度。

Objective To investigate the effect of liquid flushing lines in different temperatures and blood return in heparin-free hemodialysis patients.Methods A total of 100 heparin-free hemodialysis patients(300 times in total)were selected as study objects,and the 300 times of cases were divided into conventional group and experimental group according to the random number table method,with 150 times in each group.Normal saline at room temperature was used in the conventional group to flush the pipeline and return blood,and normal saline heated to 37℃was used in the experimental group(normal saline was prepared in the 37℃incubator in advance)to flush the pipeline and return blood.The liquid temperature,the number of liquid flushing lines,the coagulation and residual blood volume of dialyzer and blood lines,nursing comfort,physical discomfort and nursing satisfaction of the two groups were compared.Results Compared with the conventional group,the liquid temperature of the flushing line,the liquid temperature before blood return and the liquid temperature in the venous kettle in the experimental group were significantly increased(P<0.05).The flushing times of experimental group was less than that of the conventional group,and the coagulation condition of dialyzer and blood pipeline was better,and residual blood volume of dialyzer and blood pipeline was less than that of conventional group(P<0.05).The patients in the experimental group did not have cold upper limbs,body chills and other phenomena.Nursing comfort and nursing satisfaction in the experimental group were higher than those in the conventional group(P<0.05).Conclusion The use of normal saline heated to a suitable temperature(37℃)to flush the pipeline and return blood can effectively improve the comfort of patients with heparin-free hemodialysis,reduce the occurrence of low temperature in the upper limb and cold in the body,improve the clotting condition of the pipeline,reduce the number of flushing pipes and residual blood volume,and improve the patient′s nursing satisfaction.