静脉血液透析滤过治疗严重脓毒症患者的护理探讨  

Nursing exploration of patients with severe sepsis treated by venous hemodiafiltration

作　　者：戴卫华[1] 谢波[1] 周庆[1] 邵丽芬 DAI Weihua;XIE Bo;ZHOU Qing;SHAO Lifen(Intensive Care Unit, Huzhou Central Hospital in Zhejiang Province, Huzhou 313000, China)

机构地区：[1]浙江省湖州市中心医院重症医学科

出　　处：《中国现代医生》2019年第15期136-139,共4页China Modern Doctor

基　　金：浙江省卫计委科技平台项目(2017ZD027)

摘　　要：目的探讨严重脓毒症患者应用静脉血液透析滤过治疗的临床护理效果。方法研究对象为我院2014年9月~2017年10月收治的146例静脉血液透析滤过治疗法严重脓毒症患者,所有患者均符合严重脓毒症的诊断标准,将患者随机分为研究组(n=73)和对照组(n=73),两组脓毒症患者均选择静脉血液透析滤过治疗,对照组的73例患者接受常规护理,研究组的73例患者接受针对性护理干预,比较两组患者的医院焦虑抑郁情绪测量表(HAD量表)评分,临床指标(血红蛋白、CVP、MPAP、PCWP)以及满意率。结果研究组患者护理后抑郁评分、焦虑评分分别为(29.66±1.74)分、(39.25±1.28)分,明显低于对照组的护理后的(49.36±2.25)分、(56.25±3.54)分;研究组患者护理后的血红蛋白、CVP、MPAP、PCWP分别为(114.9±3.3)g/L、(11.2±0.8)mmHg、(18.3±0.9)mmHg、(8.6±0.6)mmHg优于对照组的(103.3±1.8)g/L、(11.6±1.3)mmHg、(25.6±1.8)mmHg、(13.6±0.7)mmHg;研究组患者护理后其不良事件发生率为12.33%,明显低于对照组的42.47%。此外,研究组的满意率明显高于对照组。结论针对严重脓毒症患者静脉血液透析滤过治疗后采用针对性护理干预可以起到较好的效果,降低不良反应的发生率,改善患者的焦虑和抑郁情绪,提高患者的满意率。Objective To investigate the clinical nursing effect of venous hemodiafiltration in patients with severe sepsis. Methods 146 patients with severe sepsis treated with venous hemodiafiltration in our hospital from September 2014 to October 2017 were enrolled. All patients met the diagnostic criteria for severe sepsis and were randomly divided into study group(n=73) and control group(n=73). Venous hemodiafiltration treatment was selected in both groups of sepsis patients.73 patients in the control group received routine care, and 73 patients in the study group were treated with targeted nursing intervention. The hospital anxiety and depression measures(HAD scale) scores, clinical indicators (hemoglobin, CVP, MPAP, PCWP) and satisfaction rates between two groups were compared. Results The post-nursing depression score and anxiety score of the study group were(29.66±1.74) and (39.25±1.28), which were significantly lower than(49.36±2.25) and(56.25±3.54) of the control group. After nursing, the hemoglobin, CVP, MPAP, and PCWP of the study group were (114.9±3.3) g/L,(11.2±0.8) mmHg,(18.3±0.9) mmHg, and (8.6±0.6) mmHg, respectively, which were superior to (103.3±1.8) g/L,(11.6±1.3) mmHg,(25.6±1.8) mmHg,(13.6±0.7) mmHg in the control group. The incidence of adverse events in the study group was 12.33%, significantly lower than that in the control group(42.47%). In addition, the satisfaction rate of the study group was significantly higher than that of the control group. Conclusion Targeted nursing intervention for patients with severe sepsis after venous hemodiafiltration can achieve good results, reduce the incidence of adverse reactions, improve patients' anxiety and depression, and improve patient satisfaction rate.

关 键 词：严重脓毒症 静脉血液透析滤 针对性护理干预 焦虑评分 抑郁评分 

分 类 号：R459.7[医药卫生—急诊医学]