尿毒症合并心力衰竭患者的护理干预(1)
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[摘要] 目的：探讨连续性肾脏替代治疗(CRRT)尿毒症合并心力衰竭患者的护理干预。方法：尿毒症合并心力衰竭的患者70例，分为治疗组连续性肾脏替代治疗(CRRT)38例，对照组常规血透(HD)32例，观察两组疗效和护理干预效果。结果：治疗组38例，显效10例(26.3%)，有效18例(47.4%)，无效10例(26.3%)，总有效28例(73.3%)；对照组32例， 显效5例(15.6%)，有效11例(34.4%)，无效16例(50.0%)，总有效16例(50.0%)。治疗组总有效率明显高于对照组(χ2=3.95，P<0.05)。结论：连续性肾脏替代治疗尿毒症合并心力衰竭患者的护理干预能改善患者的心功能，提高其生活质量。
[关键词] 连续性肾脏替代治疗；尿毒症；心力衰竭；护理
[中图分类号] R473.5[文献标识码]C [文章编号]1673-7210(2008)12(b)-130-02
Nursing intervention of uremia patients complicated with heart failure
ZHOU Feng-ying
(Department of Kidney Medicine, Huizhou Central Hospital, Guangdong Province, Huizhou516001, China)
[Abstract] Objective: To study the nursing intervention of uremia patients complicated with heart failure by continuous renal replacement therapy(CRRT). Methods: The 70 uremia patients complicated with heart failure were divided into two groups, the treatment group of CRRT 38 cases and the control group of conventional hemodialysis(HD) 32 cases. The efficacy and effectiveness of nursing intervention were observed. Results: In the 38 cases of treatment group, 10 cases had marked effect (28.3%), 18 cases were effective (47.4%), 16 cases (26.3%) without effect, the total efficiency was 73.3%; In the 32 cases of control group, There were 5 cases (15.6%) with marked effect, 11 cases (34.4%) with effect, 16 cases (50.0%) without effect, total efficiency was 50.0%; The total efficiency of treatment group were significantly higher than that control group(χ2=3.95, P<0.05). Conclusion: Continuous renal replacement therapy in patients with uremia with heart failure care and intervention can improve the patient's heart function, improve their quality of life.
[Key words] Continuous renal replacement therapy; Uremia; Heart failure; Care
心力衰竭是尿毒症患者的严重并发症之一，也是最常见的死亡原因，过去采用调整血液透析处方，去除心力衰竭诱因，并辅以药物对症治疗，但疗效不佳。近年来，我院采用连续性肾脏替代治疗(CRRT)技术对尿毒症合并心力衰竭患者进行了治疗和护理，取得满意疗效。现总结如下：
1资料与方法
1.1临床资料
收集我院2005年7月～2008年7月尿毒症合并心力衰竭的患者70例(男42例，女28例)，年龄35～75岁，平均51.5岁；病程3～11年，平均5年；引起尿毒症的原因：慢性肾小球肾炎17例(24.3%)，糖尿病15例(21.4%)，高血压肾病12例(17.7%)，梗阻性肾病10例(14.3%)，狼疮性肾炎8例(11.4%)，痛风肾病4例(5.7%)，慢性肾盂肾炎4例(5.7%)；引发心力衰竭(心衰)的诱因：呼吸道感染18例(25.7%)，3级高血压13例(18.6%)，泌尿系统感染12例(17.1%)，劳累8例(11 ......
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