结肠途径治疗机治疗慢性肾功能不全46例的疗效及护理  

Colonic Lavage in Treatment of Chronic Renal Insufficiency:Outcome and Nursing Observation of 46 Cases

作　　者：郝璐[1] 严首春[1] 傅菊芳[2] 张运涛[3] 杨喜忠[4] 

机构地区：[1]第四军医大学西京医院急诊科,西安710032 [2]西京医院护理部 [3]西京医院泌尿外科 [4]西京医院药局

出　　处：《解放军护理杂志》2007年第2期15-17,共3页Nursing Journal of Chinese People's Liberation Army

摘　　要：目的探讨结肠途径治疗机治疗慢性肾功能不全的临床疗效及护理。方法将慢性肾功能不全患者46例分为两组,全部病例均给予优质低蛋白饮食并予以纠正酸中毒、控制高血压等对症处理,其中实验组采用北京晟威电子医疗设备有限公司生产的IMS-100A型结肠途径治疗机进行结肠途径灌洗治疗,每日治疗1次,10 d为1个疗程,均为3个疗程,同时根据患者临床表现选择相应的对症治疗。对照组采用同样灌洗液,常规保留灌肠,时间60 min,每日治疗1次,10 d为1个疗程,均为3个疗程。观察两组的临床症状(便秘、纳差、恶心、呕吐、皮肤瘙痒、手足麻木、淡漠、嗜睡、贫血及营养状况)及治疗前后血尿素氮(BUN)、血肌酐(Scr)、内生肌酐清除率(Ccr)和24 h尿蛋白定量(TP),并对两组的治疗效果进行评价。结果两组患者治疗后常见临床症状如恶心、呕吐、胃纳差、乏力等明显减轻或消失,治疗组明显优于对照组(P<0.05)。两组患者治疗后血BUN、Scr较治疗前明显降低,Ccr、Alb较治疗前明显增高,但治疗组比对照组改善明显,两组相比差异显著(P<0.05)。结论结肠途径治疗机治疗慢性肾功能不全,克服了传统灌肠方式只能达直肠段的缺点,充分扩大了滤过面积,能更充分彻底地清除体内的有毒物质,并促进肠黏膜吸收药物,达到治疗目的,其治疗效果优于传统的灌肠法;护理上应加强病情观察、心理护理及专科护理。Objective To study the therapeutic effect of colonic lavage in treatment of chronic renal insufficiency and the related nursing management. Methods Forty-six patients with chronic renal insufficiency were given high-quality low-protein diet, acidosis correction, and hypertension control, and then were assigned to 2 groups：experimental group and control group. Patients in the experimental group received colonic lavage by IMS-100A instrument （Beijing Chengwei Electronic Medical Equipment Co. LTD）, for 1 h daily for 30 days） ; those in control group were given the same lavage fluid and for the same course by traditional lavage. The clinical symptoms, including constipation, poor appetite, nausea, vomiting, itch of skin, limb numbness, apathy, lethargy, anemia,and nutritional status, were observed and the BUN, Scr, Ccr, 24 hour TP were detected before and after treatment. Results The clinical symptoms, such as nausea, vomiting, poor appetite and acratia, etc , were obviously improved or disappeared in both groups, with the improvement in the experimental group significantly better than that in the control group（ P〈0.05）. Blood BUN and Scr were notably decreased and Ccr and Alb were increased after treatment in both groups, also with the improvement in the experimental group significantly better than that in the control group（ P〈0.05）. Conclusion The present colonic lavage instrument is superior to the conventional lavage method in the treatment of chronic renal insufficiency; it can reach more segments other than the rectum, expanding the filtration area, clearing the toxic substances and enhancing the drug absorption by intestinal mucosa. The nursing management should focus on the patient observation, psychological caring and specific nursing.

关 键 词：慢性肾功能不全 结肠途径治疗机 疗效 护理 

分 类 号：R692.5[医药卫生—泌尿科学]