针对性临床干预在连续肾脏替代疗法治疗儿童危重症合并急性肾衰竭中的安全性研究  

Safety of targeted clinical intervention in continuous renal replacement therapy for critically ill children with acute renal failure

作　　者：吴宝玲[1] 童阿英 王瑜 WU Baoling;TONG Aying;WANG Yu(Pediatric Intensive Care Unit,the First Affiliated Hospital of Xiamen University,Xiamen,Fujian 360000,China;Department of Health Management,180th Hospital of the Chinese People′s Liberation Army,Quanzhou,Fujian 362000,China)

机构地区：[1]厦门大学附属第一医院PICU,福建厦门360000 [2]解放军第一八〇医院健康管理科,福建泉州362000

出　　处：《现代医药卫生》2023年第8期1328-1331,1335,共5页Journal of Modern Medicine & Health

基　　金：福建省泉州市科学技术局科技计划项目(2013Z56)。

摘　　要：目的探讨针对性临床干预在连续肾脏替代疗法(CRRT)治疗儿童危重症合并急性肾衰竭(ARF)中的安全性。方法将2019年6月至2021年12月厦门大学附属第一医院收治的66例危重症合并ARF患儿按就诊顺序随机分为对照组和观察组,每组33例。2组均进行常规基础治疗与CRRT,对照组给予常规护理方案,观察组给予针对性临床干预方案。观察2组患儿基础生命体征、不同时间点儿科危重症评分(PCIS)、并发症发生情况和护理满意度。结果观察组患儿CRRT后24、27 h,1周PCIS提高程度均明显优于对照组,且2组患儿PCIS随时间推移均呈逐步升高趋势,差异均有统计学意义(P<0.05)。2组患儿干预后基础生命体征均有不同程度降低,且观察组患儿干预后基础生命体征降低程度明显优于对照组,差异均有统计学意义(P<0.05)。与对照组比较,观察组患儿并发症发生率明显降低,护理满意度明显提高,差异均有统计学意义(P<0.05)。结论采用针对性临床干预在CRRT治疗儿童危重症合并ARF的临床应用中是安全、有效的。Objective To explore the safety of targeted clinical intervention in continuous renal replacement therapy(CRRT)for critically ill children with acute renal failure(ARF).Methods A total of 66 critically ill children with ARF admitted from June 2019 to December 2021 in the First Affiliated Hospital of Xiamen University according to the order of consulation were randomly divided into the control group and an the observation group,with 33 patients in each group.Both groups received routine basic treatment and CRRT.The control group received routine nursing plan,while the observation group received targeted clinical intervention plan.The basic vital signs,pediatric critical illness score(PCIS)at different time points,complications and nursing satisfaction of the two groups were observed.Results The improvement of PCIS in the observation group was significantly better than that in the control group at 24 hours,27 hours and one week after CRRT,and the trend of PCIS in the two groups was gradually increasing over time,with significant differences(P<0.05).After the intervention,the basic vital signs of children in both groups decreased in different degrees,and the reduction degree of the basic vital signs in the observation group was significantly better than that in the control group,with significant differences(P<0.05).Compared with the control group,the incidence of complications in the observation group decreased and the nursing care improved,with significant differences(P<0.05).Conclusion Targeted clinical intervention is safe and effective in the clinical application of CRRT in the treatment of critical illness children with ARF.

关 键 词：儿童 危重病 急性肾功能衰竭 安全 针对性临床干预 连续肾脏替代疗法 

分 类 号：R726.9[医药卫生—儿科]