血液滤过置换在多发伤致多器官功能障碍综合征患者行血液滤过治疗中的应用

摘要

目的 在对多发伤致多器官功能障碍综合征(MODS)患者进行床旁血液滤过的治疗中,探讨血液滤过置换基础液应用于临床的效果.方法 选择2011年3月~2011年7月我院收治的多发性创伤致MODS行床旁血液滤过治疗患者23例,监测患者应用血液滤过置换基础液进行血滤治疗前后心率、平均动脉压、氧合指数,测定肌酐、尿素氮和电解质变化,观察血滤治疗前后急性生理学及慢性健康状况评分Ⅱ(APACHE Ⅱ评分)和MODS评分的变化,测量护士应用置换基础液进行置换液配方配制所需的时间.结果 好转19例,死亡4例;23例平均APACHE Ⅱ评分和MODS评分均降低,血清尿素氮、肌酐、钾与治疗前比较显著降低(P<0.05).治疗中未发现明显的不良反应,护士进行1袋置换液配制的时间由原来的8min缩短至1.5min.结论 使用血液滤过置换基础液,治疗性能稳定,简化护理流程,可以降低人力、物力成本,提高临床护理质量.%Objective To investigate the effect of the basic substitute fluid Mr bedside hemo-filtration ther-apy in patients with multiple organ dysfunction syndrome(MODS)caused by multi-trauma.Methods From Mar.201 1 to Jul.201 1,a total of 23 patients with MODS caused by multi-trauma were treated by beside hemo-filtration with the basic substitute fluid.The heart rate(HR),average blood pressure(ABP),oxygenation,ereatinine(Cr),blood urine nitrogen(BUN),electrolyte were monitored before and after the hemo-filtration using basic substitute flu-id.The changes of the score of APACHE Ⅱ and MODS were investigated before and after the hemofiltration with basic substitute fluid,and the time of the basic substitute fluid preparation by the nursing staff was determined.Re-suits Of the 23 patients,19 patients improved,4 patients died.The scores of APACHE Ⅱ and MODS went down after the hemo-filtration in aⅡthe 23 patients.The BUN,Cr,blood potassium significantly reduced after the hemo-filtration in all the 23 patients.The preparing time Mr the basic substitute fluid was shortened from 8 minutes to 1.5 minutes by the nursing staff.There was no side effect through the whole treating progress.Conclusion The basic substitute fluid can stablize the treatment process,simplify the nursing progress,reduce the costs,and improve the nursing process while performing the hemofiltration therapy.