医护一体化动态管理在重症监护病房危重患者连续性肾脏替代治疗中超滤量管理的应用效果

doi:10.3969/j.issn.1008-9691.2020.03.011

科研成果详情

题名	医护一体化动态管理在重症监护病房危重患者连续性肾脏替代治疗中超滤量管理的应用效果
其他题名	Research on application effect of continuous renal replacement therapy managed by curing and nursing integrative dynamic for critical patients in intensive care unit
作者	徐晓微1; 王晓蓉1; 周慧芬1; 范栩妃1; 范兴恳 2; 何爱文1; 林碎钗1; 陈小华 1
发表日期	2020
发表期刊	中国中西医结合急救杂志影响因子和分区
语种	中文
原始文献类型	期刊论文
关键词	医护一体化动态管理重症监护病房危重患者治疗目标达成率连续性肾脏替代治疗超滤量并发症
摘要	目的探讨医护一体化动态管理在重症监护病房(ICU)危重患者连续性肾脏替代治疗(CRRT)中超滤量管理的应用效果。方法选择2017年9月至2018年4月入住温州医科大学附属第一医院ICU采用常规管理的49例CRRT患者作为常规组;以2018年5月至12月入住ICU实施CRRT医护一体化动态管理的49例患者作为干预组。比较两组患者的治疗目标达成率和急性生理学与慢性健康状况评分Ⅱ(APACHE Ⅱ)的差异;并观察两组患者低血压、心律失常、肺水肿等CRRT并发症的发生率。结果干预组溶质控制指标、供给剂量/处方剂量比值及有效治疗时间等治疗目标达成率明显高于常规组(分别为97.96%比83.67%,93.88%比77.55%,95.92%比81.63%,均P<0.05)。两组患者第1个24 h APACHE Ⅱ比较差异无统计学意义(P>0.05);干预72 h后,干预组APACHE Ⅱ评分明显低于常规组(分:14.31±4.72比19.57±6.83,P<0.05)。干预组低血压、心律失常、肺水肿等CRRT并发症的发生率明显低于常规组〔6.12%(3/49)比24.48%(12/49),P<0.05〕。结论对ICU危重CRRT患者实施医护一体化动态管理,能有效提高治疗目标达成率,降低血压、心律失常、肺水肿等CRRT并发症的发生率,值得临床推广。
其他摘要	Objective To discuss the effect of applying curing and nursing integrative dynamic method in management of ultrafiltration amount in continuous renal replacement therapy (CRRT) for critical patients in intensive care unit (ICU). Methods Forty-nine CRRT patients were selected to be in a conventional group managed routinely from September 2017 to April 2018 in the ICU of the First Affiliated Hospital of Wenzhou Medical University; other 49 CRRT patients were arranged in an intervention group and managed by curing and nursing integrative dynamic method in the ICU of this hospital from May to December 2018. The differences in achievement rate of therapeutic goal and acute physiology and chronic health evaluation Ⅱ (APACHE Ⅱ) score were compared between the two groups; the incidences of CRRT complications including hypotension, arrhythmia, pulmonary edema, etc. in the two groups were observed. Results The achievement rates of therapeutic goals including solute control index, supply dose/prescription dose ratio and effective treating time of intervention group were significantly higher than those in the conventional group (97.96% vs. 83.67%, 93.88% vs. 77.55%, 95.92% vs. 81.63% respectively, all P < 0.05). The difference of first 24 hours APACHE Ⅱ between the two groups had no statistical significance (P > 0.05); the APACHE Ⅱ score of intervention group was significantly lower than that in the conventional group after 72 hours of intervention (14.31±4.72 vs. 19.57±6.83, P < 0.05). The incidence of CRRT complications such as hypotension, arrhythmia and pulmonary edema in the intervention group was significantly lower than that in the conventional group [6.12% (3/49) vs. 24.48% (12/49), P < 0.05]. Conclusion Applying curing and nursing integrative dynamic management for ICU CRRT critical patients can effectively raise the achievement rate of treatment goals and lower the incidence of CRRT complications including hypotension, arrhythmia and pulmonary edema, which is worthy of clinical promotion.
资助项目	浙江省温州市公益性科技计划项目 ; 浙江省医药卫生科技计划项目
ISSN	1008-9691
卷号	27 期号:3 页码:301-305
DOI	10.3969/j.issn.1008-9691.2020.03.011
页数	5
收录类别	CSCD ; 万方 ; 维普 ; PKU ; 北大核心 ; ISTIC
学科领域	医药、卫生
URL	查看原文
CSCD记录号	CSCD:6741667
引用统计
文献类型	期刊论文
条目标识符	https://kms.wmu.edu.cn/handle/3ETUA0LF/99072
专题	附属第一医院其他_附属苍南医院（苍南县人民医院）
作者单位	1.温州医科大学附属第一医院, 浙江, 温州, 325000 ; 2.温州医科大学附属苍南医院, 浙江, 温州, 325899
第一作者单位	附属第一医院
第一作者的第一单位	附属第一医院
推荐引用方式 GB/T 7714	徐晓微,王晓蓉,周慧芬,等. 医护一体化动态管理在重症监护病房危重患者连续性肾脏替代治疗中超滤量管理的应用效果[J]. 中国中西医结合急救杂志,2020,27(3):301-305.
APA	徐晓微., 王晓蓉., 周慧芬., 范栩妃., 范兴恳., ... & 陈小华. (2020). 医护一体化动态管理在重症监护病房危重患者连续性肾脏替代治疗中超滤量管理的应用效果. 中国中西医结合急救杂志, 27(3), 301-305.
MLA	徐晓微,et al."医护一体化动态管理在重症监护病房危重患者连续性肾脏替代治疗中超滤量管理的应用效果".中国中西医结合急救杂志 27.3(2020):301-305.