6例特重度烧伤患者使用体外膜肺氧合联合连续性肾脏替代治疗的护理  

Nursing care of 6 patients with severe burn treated with extracorporeal membran pulmonary oxygena tion and continuous renal replacement therapy

作　　者：曾妃[1] 梁江淑渊 金小娟[1] 封秀琴[2] ZENG Fei;LIANG Jiangshuyuan;JIN Xiaojuan;FENG Xiuqin

机构地区：[1]浙江大学医学院附属第二医院综合ICU,杭州市310000 [2]浙江大学医学院附属第二医院护理部,杭州市310000

出　　处：《中华护理杂志》2021年第3期364-367,共4页Chinese Journal of Nursing

基　　金：浙江省医药卫生科技计划项目(2020KY574,2021KY169)。

摘　　要：总结体外膜肺氧合联合连续性肾脏替代治疗救治6例特重度烧伤患者的护理经验。护理要点:体外膜肺氧合联合连续性肾脏替代治疗运行中,全程化压力监测;制订个体化液体管理方案,确保容量足够;精准化抗凝管理,防止滤器凝血,同时关注创面渗血、渗液;成立感染控制专职团队,严防感染;早期保暖措施干预,防止发生低体温;在保护烧创伤皮肤的前提下,妥善固定导管。体外膜肺氧合联合连续性肾脏替代治疗过程中,无一例出现导管脱落、导管接口渗血、置管部位皮肤感染、治疗设备异常停机、出血等。To summarize the nursing experience of 6 severe burn patients with extracorporeal membrane oxygenation(ECMO) and continuous renal replacement therapy(CRRT). Nursing points:the whole process pressure monitoring;the development of individualized liquid management plan to ensure adequate capacity;the precise anticoagulation management to prevent blood clotting in filter and the special attention to wound drainage;the establishment of a full-time team for infection control to strictly prevent infection;under the premise of protecting the burned skin. During the treatment of ECMO combined with CRRT,no one was found with any complications such as tube shedding,tube bleeding,nozzle skin infection,abnormal shutdown of ECMO and CRRT,or bleeding.

关 键 词：体外膜肺氧合 连续性肾脏替代治疗 特重度烧伤 重症监护 

分 类 号：R473.6[医药卫生—护理学]