改良置换液配方在重症维持性血液透析患者日间间歇性连续性肾脏替代治疗中的应用效果  

The Application Effect of Improved Replacement Fluid Formula in Daytime Intermittent CRRT for Patients with Severe Maintenance Hemodialysis

作　　者：陶玲玲[1] 程静[1] TAO Ling-ling;CHENG Jing(Hemodialysis Unit,the First Affiliated Hospital of Nanchang University,Nanchang 330006,China)

机构地区：[1]南昌大学第一附属医院血透室,南昌330006

出　　处：《实用临床医学（江西）》2024年第5期85-88,111,共5页Practical Clinical Medicine

基　　金：江西省卫健委科技计划项目(20203179)。

摘　　要：目的探讨改良置换液配方在重症持续性血液透析患者日间间歇性连续性肾脏替代治疗(CRRT)中的应用效果。方法选择南昌大学第一附属医院2022年7月至2023年7月收治的重症持续性血液透析患者30例为研究对象,所有患者均采用日间间歇性CRRT治疗,按随机数字表法分为对照组与观察组,每组15例。对照组使用原有配套置换液配方,观察组采用改良置换液配方。治疗3个月后比较2组肾功能及血糖、钾、钠、氯、钙、血气水平及不良事件发生率。结果观察组上机后尿素氮(BUN)、血肌酐(Scr)水平显著低于对照组(P<0.05),钾、钠、氯、钙水平显著高于对照组(P<0.05);观察组上机6 h、下机后pH值及HCO3-水平显著高于对照组(P<0.05)。2组干预过程中低血糖、感染、失衡综合征、低血压及造瘘口病变发生率比较差异无统计学意义(P>0.05)。结论改良置换液配方用于重症持续性血液透析患者日间间歇性CRRT,能提升患者肾功能,有助于改善血糖、钾、钠、氯、钙、血气水平,且不增加不良事件发生率。Objective To explore the application effect of improved replacement fluid formula in daytime intermittent continuous renal replacement therapy(CRRT)for patients with severe maintenance hemodialysis.Methods 30 patients with severe maintenance hemodialysis admitted to the First Affiliated Hospital of Nanchang University from July 2022 to July 2023 were selected as the study subjects.All patients underwent daytime intermittent CRRT and were divided into a control group and an observation group using a random number table method,with 15 patients in each group.The control group received the original standard replacement fluid formula,while the observation group received an improved replacement fluid formula.After 3 months of treatment,renal function,blood glucose,potassium,sodium,chloride,calcium,blood gas levels,and the incidence of adverse events were compared between the 2 groups.Results The levels of blood urea nitrogen(BUN)and serum creatinine(Scr)in the observation group were significantly lower than those in the control group after starting the machine(P<0.05),while the levels of potassium,sodium,chloride,and calcium were significantly higher than those-in the control group(P<0.05);The pH value and HCO3 level in the observation group were significantly higher than those in the control group at 6 hours after starting the machine and after stopping the machine(P<0.05).There were no statistically significant differences in the incidence of hypoglycemia,infection,disequilibrium syndrome,hypotension,and fistula lesions between the 2 groups during the intervention process(P>0.05).Conclusion Improved replacement fluid formula can enhance renal functions in daytime intermittent CRRT for patients with severe persistent hemodialysis,contributing to improving the levels of blood glucose,potassium,sodium,chlorine,calcium,and blood gas,without increasing the incidence of adverse events.

关 键 词：改良置换液配方 重症持续性血透 连续性肾脏替代治疗 日间间歇性 

分 类 号：R473.5[医药卫生—护理学]