摘要
目的 系统评价连续性肾脏替代治疗(CRRT)患者非计划性下机的影响因素。方法 采用计算机检索中国知网、万方、维普、Pub Med、EMbase等数据库中已发表的相关文献。检索时限为建库至2022年3月。采用meta分析CRRT非计划下机的影响因素。结果 本研究共纳入研究文献16篇,共2 289例患者。延长活化部分凝血活酶时间[HR=0.939,95%CI(0.899,0.992),P<0.001]是CRRT非计划性下机的保护因素。高血小板计数[HR=1.002,95%CI(1.000,1.004),P<0.001]、低血流速[HR=1.005,95%CI(1.001,1.032),P<0.001]、高龄[OR=3.916,95%CI(2.736,5.604),P<0.001]、合并基础疾病[OR=3.386,95%CI(2.460,4.660),P <0.001]、呼吸机使用[OR=3.530,95%CI(2.051,6.074),P<0.001]、高红细胞比容[HR=1.034,95%CI(1.016,1.051),P<0.001]是CRRT非计划性下机的危险因素。结论 CRRT非计划性下机的影响因素有很多,应提高护士风险识别能力,提升预见性护理能力,改善CRRT护理质量。
Objective To systematically evaluate the influencing factors of unplanned interruption in patients on continuous renal replacement therapy(CRRT).Methods The published related literatures in CNKI,Wanfang,VIP,Pub Med,EMbase,and other databases were searched by computer.The search time was from the date of creation to March,2022.The influencing factors of unplanned disembarkation of CRRT were analyzed by meta analysis.Results A total of 16 research papers with 2 289 patients were included in this study.Prolongation of activated partial thromboplastin time(HR=0.939,95%CI [0.899,0.992],P<0.001) was a protective factor for unplanned deactivation of CRRT.High platelet count(HR=1.002,95%CI[1.000,1.004],P<0.001),low blood flow(HR=1.005,95%CI [1.001,1.032],P<0.001),advanced age(OR=3.916,95%CI[2.736,5.604],P<0.001),combined underlying disease(OR=3.386,95%CI [2.460,4.660],P<0.001),ventilator use(OR=3.530,95%CI[2.051,6.074],P<0.001),high hematocrit(HR=1.034,95%CI[1.016,1.051],P<0.001) were risk factors for unplanned disembarkation of CRRT.Conclusion There are many factors influencing the unplanned interruption of CRRT,and nurses’ risk identifi-cation ability should be improved to enhance the ability of anticipatory care and improve the quality of CRRT.
作者
陈玉倩
李文雄
杨娜
CHEN Yuqian;LI Wenxiong;YANG Na(Surgical Intensive Care Unit,Beijing Chaoyang Hospital,Capital Medical University,Beijing 100020,China)
出处
《中国医药导报》
CAS
2023年第2期105-108,113,共5页
China Medical Herald
基金
首都临床诊疗技术研究及示范应用项目(Z191100006619032)。
