高置换率CRRT在重症急性胰腺炎并发ARDS患者中的应用及护理  

Application and nursing of high replacement rate continuous renal replacement ther- apy （CRRT） in severe acute pancreatitis （SAP） complicated by acute respiratory distress syndrome （ ARDS ）

作　　者：章凤[1] 陶芳萍[1] 史倩[1] 魏登惠[1] 

机构地区：[1]蚌埠医学院第一附属医院ICU,蚌埠233004

出　　处：《国际护理学杂志》2012年第5期929-931,共3页international journal of nursing

摘　　要：目的探讨高置换率连续性。肾脏替代治疗（CRRT）在重症急性胰腺炎（SAP）并发急性呼吸窘迫综合征（ARDS）中的应用及护理。方法将24例入院时重症急性胰腺炎（SAP）并发ARDS患者于呼吸机支持下行高置换率CRRT治疗，进行动态观察治疗前后生命体征、氧合指数、APACHE-Ⅱ评分、呼气末正压（PEEP）水平等的变化。结果15例患者救治成功，经高置换率CRRT治疗后，患者的APACHE-Ⅱ评分、体温、呼吸频率、心率、平均动脉压、呼气末正压（PEEP）的水平均有明显的下降（P〈0．05），氧合指数明显升高（尸〈0．05）。结论早期应用高置换率CRRT治疗，可缓解临床症状，改善病情，提高救治成功率；而在临床上严密的监测及科学护理对重症急性胰腺炎并发急性呼吸窘迫综合征的疗效起重要作用。Objective To study the application and nursing of high replacement rate continuous renal replacement therapy （CRRT） in severe acute pancreatitis （SAP） , complicated by acute respiratory distress syndrome （ARDS） . Methods Twenty four cases of severe acute pancreatitis （SAP） concurrent ARDS patients were treated with high replacement rate CRRT treatment by ventilator support. Dynamically observing life signs, oxygenation index, APACHE - II score, positive end expiratory pressure （PEEP） level were compared be- fore and after treatment. Results Fifteen cases of patients were treated successfully on high replacement ratio CRRT therapy, the level of A- PACHE - 1] score, body temperature, breathing, heart rate, mean arterial pressure, and positive end expiratory pressure （PEEP） were sig- nificantly decreased （P 〈 0. 05 ） , oxygenation index was increased significantly （ P 〈 0.05 ） . Conclusions Early application of high re- placement rate CRRT treatment, can alleviate clinical symptoms, improve disease, improve the success rate of treatment. Moreover it plays an important role to improve therapeutic effect of severe acute panereatitis concurrent acute respiratory distress syndrome by clinical closely monitoring and scientificly nursing.

关 键 词：高置换率CRRT 重症急性胰腺炎(SAP) 急性呼吸窘迫综合征(ARDS) 护理 

分 类 号：R473.5[医药卫生—护理学]