两种补钙途径在血液滤过患者中的应用效果比较  

Effects of two calcium supplementation pathways in hemofiltration patients

作　　者：薛磊[1] 李娜[1] 韩立云 王亚平 徐阳[1] 庄小萍[1] Xue Lei;Li Na;Han Liyun;Wang Yaping;Xu Yang;Zhuang Xiaoping(Department of Critical Medicine,Peking University Third Hospital,Beijing 100191,China)

机构地区：[1]北京大学第三医院危重医学科,北京100191

出　　处：《中华现代护理杂志》2020年第12期1635-1638,共4页Chinese Journal of Modern Nursing

摘　　要：目的比较两种不同补钙途径在应用枸橼酸抗凝的血液滤过患者中的应用效果。方法采用便利抽样法,选取2018年4月-2019年3月于北京大学第三医院行血液滤过的重症患者30例作为研究对象。采用随机数字表法将患者随机分为外周静脉组和中心静脉血液滤过导管组,每组15例。外周静脉组患者经外周静脉补充钙剂,中心静脉血液滤过导管组患者经中心静脉血液滤过导管补充钙剂。上机后2、4、6、8 h时通过血气分析监测患者血清离子钙浓度达标情况并比较两组患者不良反应的发生情况。结果血气分析结果显示,两组患者血清钙离子浓度达标率在上机后2 h时差异有统计学意义(P<0.05),经中心静脉血液滤过导管补充钙剂的速率更快。上机后4、6、8 h时,两组达标率差异无统计学意义(P>0.05)。血液滤过期间,两组患者均未发生静脉炎和导管堵塞。结论两种钙剂补充方式均是安全的。血液滤过患者应用枸橼酸抗凝时,经中心静脉补充钙剂的效率更高,两种补钙方式在上机时均应加强对患者血钙的监测,防止低血钙的发生。Objective To compare the effects of two different calcium supplementation pathways in hemofiltration patients treated with citrate anticoagulation.Methods Totally 30 critical patients undergoing hemofiltration in Peking University Third Hospital from April 2018 to March 2019 were selected using convenient sampling,and randomly divided into peripheral vein group(n=15)and central vein group(n=15)according to the random number table.Patients in the peripheral vein group received calcium supplements through the peripheral vein,while patients in the central vein group received calcium supplements through the central venous hemofiltration catheter.Blood gas analysis was used to monitor the control rate of serum ion calcium concentration of the patients at 2,4,6 and 8 hours after the hemofiltration machine was started,and the incidence of adverse reactions was compared between the two groups.Results Blood gas analysis showed that there was a statistically significant difference in the control rate of serum calcium ion concentration between the two groups at 2 hours after the hemofiltration machine was started(P<0.05),and the rate of calcium supplementation through the central venous hemofiltration catheter was faster.At 4,6 and 8 hours after the hemofiltration machine was started,there was no significant difference in the control rate between the two groups(P>0.05).During hemofiltration,phlebitis or catheter obstruction did not occur in either group.Conclusions Both calcium supplementation pathways are safe.When citrate anticoagulation is used in hemofiltration patients,the efficiency of calcium supplementation through the central vein is higher.The patients'blood calcium should be monitored when the hemofiltration machine is used for either pathway to prevent hypocalcemia.

关 键 词：血液滤过 枸橼酸钠抗凝 钙剂补充 血钙浓度 护理 

分 类 号：R45[医药卫生—治疗学] R47[医药卫生—临床医学]