杂合肾脏替代治疗重症急性胰腺炎13例效果观察及护理  

Observation on the effect of hybrid renal replacement therapy in the treatment of 13 patients with severe acute pancreatitis and nursing care

作　　者：艾俊英[1] 钱艳红[1] 丁义敏[1] 罗芳[1] 王晶[1] 孙娜[1] 

机构地区：[1]长江大学附属第一医院,湖北荆州434000

出　　处：《齐鲁护理杂志（上旬刊）》2012年第12期14-16,共3页Journal of Qilu Nursing

摘　　要：目的:探讨杂合肾脏替代治疗(HRRT)重症急性胰腺炎(SAP)患者的临床效果及护理方法。方法:对13例SAP患者行HRRT,并给予安全转运与治疗衔接、血路准备、严密观察病情、心理疏导等护理措施。比较患者治疗前后生化指标变化,比较治疗前及1、2、7 d APACHEII评分,统计患者起病至治疗时间及HRRT时间,观察患者临床转归情况。结果:本组患者治疗后血清肌酐(Scr)、谷草转氨酶(AST)、谷丙转氨酶(ALT)、血淀粉酶(P-AYM)、尿淀粉酶(U-AYM)均低于治疗前(P<0.05)。本组患者治疗1、2、7 d APACHEⅡ评分均低于治疗前(P<0.01);治疗7 d APACHEⅡ评分低于治疗1 d及治疗2 d(P<0.05,P<0.01)。本组11例经HRRT及精心护理治愈出院,1例第2次HRRT后放弃继续治疗,1例第1次HRRT时抢救无效死亡。结论:HRRT是治疗SAP的一种有效措施,可提高患者的存活率,护士高度的责任心、熟练的技术、科室的有序交接是HRRT顺利进行的重要保证。Objective：To investigate the clinical effect and nursing methods in the treatment of severe acute pancreatitis （SAP） with hy-brid renal replacement therapy （ HRRT ）. Methods：13 patients with SAP underwent HRRT and were given comprehensive nursing care, including safe transportation and treatment arrangement, vascular access preparation, close observation of patients＇ conditions and psychological counseling. The change of biochemical indexes was compared before and after treatment; APACHE II scores were compared before treatment and on 1st,2nd and 7th day after treatment. The time from onset to treatment and HRRT time was statistically analyzed and patients ＇prognosis was observed. Results： The level of serum creatinine （ Scr）, aspartate aminotransferase （ AST）, alanine aminotransferase （ ALT）, serum amylase （ P - AYM ）, urine amylase （ U - AYM ） was lower after treatment than that before treatment （ P 〈 0.05 ） ; A- PACHE II scores were lower on lst,2nd and 7th day after treatment than those before treatment （P 〈 0.01 ） ;APACHE II scores were lower on 7th day after treatment than those on 1st and 2nd day after treatment （P 〈 0. 05, P 〈 0.01 ）. 11 patients were cured and discharged form hospital;one gave up treatment after the second HRRT and one patient died. Canclusion.HRRT is one of effective therapies for SAP and it can improve the patient＇ survival rate. Nurses＇ strong responsibility and skills, orderly handover between sections is the key to smooth HRRT.

关 键 词：杂合肾脏替代治疗 重症急性胰腺炎 护理 

分 类 号：R473.5[医药卫生—护理学]