摘要
目的观察联机血液透析滤过的临床疗效，探讨其技术并发症产生因素及护理措施，为临床上使用联机血液透析滤过技术提供依据或线索。方法对60例行血液透析治疗的慢性肾功能衰竭患者行联机血液透析滤过治疗1036例次，通过对临床资料回顾性研究，采用自身对照，观察血液透析滤过与血液透析治疗中临床症状及溶质的变化，总结护理体会。结果血液透析及联机血液透析滤过治疗后血肌酐、尿素氮显著下降，有统计学意义（P〈0．01）；联机血液透析滤过对β2微球蛋白清除有统计学意义（P〈0．01），血液透析对β2微球蛋白清除无统计学意义（P〉0．05）；与血液透析比，联机血液透析滤过时低血压、肌肉痉挛、恶心呕吐、骨关节疼痛、皮肤瘙痒等症状的发生率有统计学意义（P〈0．01）；首次使用滤器综合征10例次，血液透析滤过器内凝血3例次，无一例次热原反应及置换液异常输入。结论联机血液透析滤过能同时清除中、小分子尿毒症毒素；具有较好的血流动力学稳定性和耐受性；实施正确护理可减少血液透析滤过技术相关并发症，保证其安全进行。
Objective To observe the clinical effect of the online hemodiafitration （online-HDF） and discuss the occurrence factors of complications and the suitable nursing measures, so as to give a basis or clue for the application of online-HDF in clinic. Methods 60 chronic renal failure patients underwent the hemodialysis therapy were treated by online-HDF （totally 1036 times）. Through studying the clinical data retrospectively and adopting the self-control, the clinical symptoms and solutes changes during the online-HDF and the hemodialysis treatment. Then the nursing experiences were summarized. Results Both blood creatinine and urea nitrogen levels after the hemodialysis and online-HDF dropped significantly （ P 〈 0. 01 ）. As to the [32- microglobulin removal effect, the hemodialysis had no obvious influence （ P 〉 0. 05 ） , while the online-HDF had （P 〈 0. 01 ）. The common complications when receiving online-HDF included hypotension, muscle spasm, vomiting, bone arthrosis ache, and skin itch. The occurrence rates of these complications of online-HDF were smaller than those of the hemodialysis group （P 〈 0.01 ）. There were 10 cases with first-use syndrome of filter and 3 cases with coagulation in the hemodialysis filter, while no cases with heat sources reaction or displacement liquid abnormal importation. Conclusions The online-HDF could remove the median and small molecule uremia poison simultaneously. The patients could tolerate it with stable hemodynamics. The suitable nursing can lessen the HDF-related complications and guarantee the safety.
出处
《中华现代护理杂志》
2008年第16期1768-1771,共4页
Chinese Journal of Modern Nursing
