摘要目的：观察连续性肾代替疗法对危重病患者的临床治疗效果,探讨ICU连续性肾替代疗法专业护理小组的建立与实践效果评价。方法选取菏泽市立医院2013年10月—2014年10月ICU科内危重患者70例,组建连续性肾替代疗法专业护理小组,发挥专科护理小组的作用,给予危重患者行连续性肾替代疗法以及护理,并与护理小组建立前2012年10月—2013年10月的70例患者的疗效进行比较,观察危重患者治疗前后血钾、血钠、血尿素氮、血尿酸和肌酐含量的变化,测定治疗前后C反应蛋白的含量。结果连续性肾替代疗法可提高ICU抢救危重患者的成功率,140例危重患者死亡38例,5例放弃治疗,病死率为27.14%；与常规护理比较,经连续性肾代替疗法治疗及专业护理小组的综合护理后,危重患者血钾、血钠恢复正常,血尿素氮、血尿酸和肌酐的水平显著下降(P<0.01)。 C反应蛋白含量在治疗后显著下降(P<0.01)；专业护理小组的实施,降低了患者并发症的发生,同时提高了ICU连续性肾替代疗法的护理质量。结论连续性肾替代疗法治疗危重患者取得较为理想的效果,且ICU连续性肾替代疗法专业护理小组的成立及良好的运作,可保证连续性肾代替疗法的顺利进行,提高危重患者的抢救成功率。

abstractsObjective To observe the clinical effects of continuous renal replacement treatment ( CRRT) in patients with critical illness and to explore the establishment and implementation effects evaluation of CRRT professional care team in ICU. Methods A total of 70 patients with critical illness in ICU were selected from October 2013 to October 2014 in Heze Municipal Hospital. CRRT professional nursing team was established to play an important role in CRRT by providing critical ill patients with CRRT and special nursing. Clinical effects were compared with those in another 70 patients from October 2012 to October 2013 before establishing the team. Contents of blood potassium, blood sodium, blood urea nitrogen, blood uric acid and creatinine were observed and content of C-reactive protein ( CRP) was measured before and after treatment. Results CRRT could improve the success rate of treatment of ICU critical patients. Totals of 38 patients died and 5 patients gave up the treatment in 140 patients with critical illness along with mortality rate of 27. 14%. After CRRT treatment and comprehensive nursing of specialist care team, blood potassium and blood sodium of critical ill patients returned to normal level. Contents of blood urea nitrogen, blood uric acid and creatinine, CRP all significantly decreased after CRRT treatment (P <0. 01). Implementation of specialist care team reduced the incidence of complications and improved the nursing quality of ICU CRRT. Conclusions Effects of CRRT are satisfactory for patients with critical illness. Establishment and implementation of CRRT professional nursing team can ensure the smooth progress of CRRT and improve the success rate of resuscitation of critically ill patients.