应用无肝素连续肾脏替代治疗肝移植术后危重病人的护理  

Nursing care of critical patients undergoing non-heparin continuous renal replacement therapy after liver transplantation

作　　者：陈凌燕[1] 马盈盈[1] 安玉玲[1] 

机构地区：[1]中山大学附属第三医院

出　　处：《全科护理》2011年第33期3017-3019,共3页Chinese General Practice Nursing

摘　　要：[目的]总结连续性肾脏替代治疗(CRRT)治疗肝移植术后危重病人的疗效,总结护理经验。[方法]30例肝移植术后危重病人行CRRT治疗,记录CRRT治疗前后生命体征、液体平衡、电解质及APACHEⅡ评分的变化;严密监测动脉压、静脉压、跨膜压的变化;严格执行无菌操作,预冲、管路浸泡、定时用生理盐水冲管,保持体外循环畅通,与病人有效沟通。[结果]30例病人经CRRT治疗24h后内环境平衡、APACHEⅡ评分逐渐下降。所有病人治疗过程中生命体征平稳,无肝素连续性肾替代治疗得以顺利进行。[结论]CRRT是提高肝移植术后危重病人近期存活率和抢救成功率的重要措施,有效的护理干预是治疗顺利进行的关键。Objective：To summarize the effect of continuous renal replacement therapy（CRRT） on critical patients after liver transplantation and the nursing experience.Methods：A total of 30 critical patients after liver transplantation underwent CRRT,and the vital sign,fluid balance,electrolyte and change of APACHE Ⅱ scores were recorded before and after treatment.The nursing measures included monitoring arterial pressure,venous pressure,and transmembrane pressure closely;strictly aseptic operation,preshoot,pipes dipping,washing tubes regularly with physiological saline,extracorporeal circulation smoothly and effective communication and so on.Results：After 24 hours undergoing CRRT treatment,homeostatic equilibrium was reached in all patients,APACHE Ⅱ scores decreased gradually.The vital signs of all patients were stable during the treatment,and non-heparin continuous renal replacement therapy could proceed smoothly.Conclusion：CRRT is an important measure for improving survival rate and salvage achievement rate of critical patients after undergoing liver transplantation and effective nursing intervention is the key for treatment succefully.

关 键 词：肝移植 连续肾脏替代治疗 多脏器功能障碍 护理 

分 类 号：R473.6[医药卫生—护理学]