ICU患者行连续性肾脏替代治疗非计划性下机的影响因素分析

Analysis of Influencing Factors for Unplanned Weaning in ICU Patients Undergoing Continuous Renal Replacement Therapy

目的:探究ICU患者行连续性肾脏替代治疗非计划性下机的影响因素并制定预防措施。方法:选取2021年2月—2023年2月于胜利油田中心医院行连续性肾脏替代治疗的ICU患者286例作为研究对象,根据是否发生非计划性下机分为对照组(计划性下机204例)和观察组(非计划性下机82例)。收集两组临床基线资料,分析ICU患者行连续性肾脏替代治疗非计划性下机的影响因素。结果:多因素Logistic回归分析显示,凝血酶原时间短、活化部分凝血活酶时间短、静脉压高、护士同时负责机器数量≥3台、抗凝方式为低分子肝素均是ICU患者行连续性肾脏替代治疗非计划性下机的独立危险因素(P<0.05)。结论:凝血酶原时间短、活化部分凝血活酶时间短、静脉压高、护士同时负责机器数量≥3台、抗凝方式为低分子肝素是ICU患者行连续性肾脏替代治疗非计划性下机的独立危险因素,临床应根据上述因素并结合实际情况制定一系列科学合理的防治措施,以降低非计划性下机发生率。

Objective:To explore the influencing factors for unplanned weaning in ICU patients undergoing continuous renal replacement therapy(CRRT)and formulate the preventive measures.Methods:A total of 286 ICU patients who underwent continuous renal replacement therapy in Shengli Oilfield Central Hospital from February 2021 to February 2023 were selected as the study subjects.According to whether unplanned weaning occurred,they were divided into the control group(204 planned weaning times)and the observation group(82 unplanned weaning times).The clinical baseline data of the two groups were collected.The influencing factors for unplanned weaning in ICU patients undergoing continuous renal replacement therapy were analyzed.Results:Multivariate Logistic regression analysis showed that,short prothrombin time,short activated partial thromboplastin time,high venous pressure,≥3 machines in charge of nurses concurrently,and anticoagulation mode of low molecular weight heparin were independent risk factors for unplanned weaning in ICU patients undergoing continuous renal replacement therapy(P<0.05).Conclusion:Short prothrombin time,short activated partial thromboplastin time,high venous pressure,≥3 machines in charge of nurses concurrently,and anticoagulation mode of low molecular weight heparin are independent risk factors for unplanned weaning in ICU patients undergoing continuous renal replacement therapy.Clinically,a series of scientific and reasonable preventive measures should be formulated according to the above factors and the actual situation to reduce the incidence of unplanned weaning.