国际护理学杂志
國際護理學雜誌
국제호이학잡지
INTERNATIONAL JOURNAL OF NURSING
2011年
7期
969-971
,共3页
汤红莲%苏冰莲%杨永英%刘容丽%莫小红
湯紅蓮%囌冰蓮%楊永英%劉容麗%莫小紅
탕홍련%소빙련%양영영%류용려%막소홍
无抗凝剂%换瓣手术%急性肾功能衰竭%CVVH%护理
無抗凝劑%換瓣手術%急性腎功能衰竭%CVVH%護理
무항응제%환판수술%급성신공능쇠갈%CVVH%호리
Non-anticoagulants%Valve surgery%Acute renal failure%CVVH%Nursing
目的 探讨换瓣术后急性肾功能衰竭患者无抗凝剂行连续性静脉-静脉血液滤过 (CVVH)治疗的护理.方法 对28例心脏直视换瓣术后并发急性肾功能衰竭(ARF)的患者实施无抗凝剂CVVH治疗138例次,治疗过程中密切观察滤器和管道的血凝情况、采用定时冲洗管路等护理措施.结果 本组治疗138例次,滤器寿命3.5~24 h,多数为10~13 h,连续治疗者每天更换1~2套滤器及管路;1例在连续4次治疗中机械反复出现低压动脉报警,造成滤及管路在3.5~7 h凝血而更换滤器及管路,2例病人出现皮下出血点,1例病人出现血便.结论 对换瓣术后ARF的患者进行CVVH无抗凝剂治疗,结合相应护理措施,能使治疗能顺利完成,减小患者出血并发症.
目的 探討換瓣術後急性腎功能衰竭患者無抗凝劑行連續性靜脈-靜脈血液濾過 (CVVH)治療的護理.方法 對28例心髒直視換瓣術後併髮急性腎功能衰竭(ARF)的患者實施無抗凝劑CVVH治療138例次,治療過程中密切觀察濾器和管道的血凝情況、採用定時遲洗管路等護理措施.結果 本組治療138例次,濾器壽命3.5~24 h,多數為10~13 h,連續治療者每天更換1~2套濾器及管路;1例在連續4次治療中機械反複齣現低壓動脈報警,造成濾及管路在3.5~7 h凝血而更換濾器及管路,2例病人齣現皮下齣血點,1例病人齣現血便.結論 對換瓣術後ARF的患者進行CVVH無抗凝劑治療,結閤相應護理措施,能使治療能順利完成,減小患者齣血併髮癥.
목적 탐토환판술후급성신공능쇠갈환자무항응제행련속성정맥-정맥혈액려과 (CVVH)치료적호리.방법 대28례심장직시환판술후병발급성신공능쇠갈(ARF)적환자실시무항응제CVVH치료138례차,치료과정중밀절관찰려기화관도적혈응정황、채용정시충세관로등호리조시.결과 본조치료138례차,려기수명3.5~24 h,다수위10~13 h,련속치료자매천경환1~2투려기급관로;1례재련속4차치료중궤계반복출현저압동맥보경,조성려급관로재3.5~7 h응혈이경환려기급관로,2례병인출현피하출혈점,1례병인출현혈편.결론 대환판술후ARF적환자진행CVVH무항응제치료,결합상응호리조시,능사치료능순리완성,감소환자출혈병발증.
Objective To study the observation and nursing with continuous veno- venous hemofiltration (CVVH) without anticoagulation therapy in acute renal failure after valve surgery.Methods During the treatment with 138 times of non-anticoagulant CVVH in open heart valve replacement surgery with concurrent acute renal failure (ARF) in 28 cases, the condition variation, filters and piping clotting conditions were closely observed, and regular flushing piping and other nursing measures were taken.Results In the treatment of 138 times, filter life was 3.5 ~ 24 h, 10 ~ 13 h in the majority; continuous treatment replaced 1 to 2 sets of filters and pipes one day; one case of 4 times treatment in a row occurred recurrent mechanical alarm of hypotension, causing coagulation in filters and pipes in 3.5 ~ 7 h and replacement of filters and pipes; 2 patients occurred subcutaneous bleeding, and 1 patient had bloody stools.Conclusions In the patients with ARF after valve surgery, CVVH without anticoagulation therapy, combined with the appropriate care measures, can make the successful completion of treatment and reduce bleeding complications in patients.