连续白蛋白净化系统的临床应用及护理体会
|
摘要
目的本文旨在对7例重症肝病患者进行连续白蛋白净化系统治疗中的临床应用及护理体会进行报道。方法选择我中心7例患者进行10次连续白蛋白净化系统(CAPS)治疗。治疗参数:血流速100~120 ml/min,白蛋白循环与之等速,透析液流速40~50 ml/min;治疗时间8~12 h,脑水肿、肝肾综合征者延长治疗可达24 h。结果 CAPS治疗的重症肝病患者中,2例死亡,1例为慢性重型肝炎晚期多器官功能障碍综合征(MODS),另1例为肾移植术后应用免疫抑制剂诱发纤维淤胆型肝炎、肝衰竭,存活率达57.1%。结论护理人员应针对患者不同的心理状态进行相应的心理护理,并争取患者家属的理解和配合,使其治疗得以顺利进行。
Objective This article aims to report the clinical application and nursing experience on 7 patients of severe liver disease treated with continuous albumin purification system. Methods Choose 7 patients in our center to CAPS treatment for 10 times. Treatment parameters: blood flow rate of 100-120 ml/min, albumin cycle with constant velocity, the dialysate flow rate of 40-50 ml/min; Treatment time 8-12 h generally, treatment time of patients with cerebral edema, liver and kidney syndrome, was prolonged up to 24 h. Results Among patients with severe liver disease treated with CAPS, 2 cases died, 1 case of late MODS with chronic severe hepatitis, the other of immunosuppression induced fibrosing cholestatic hepatitis and liver failure after renal transplantation, survival rate was 57.1%. Conclusion Nurses should make the appropriate psychological care for patients with different mental states, and try to make patients' families understand and cooperate, making its treatment smoothly.
Objective This article aims to report the clinical application and nursing experience on 7 patients of severe liver disease treated with continuous albumin purification system. Methods Choose 7 patients in our center to CAPS treatment for 10 times. Treatment parameters: blood flow rate of 100-120 ml/min, albumin cycle with constant velocity, the dialysate flow rate of 40-50 ml/min; Treatment time 8-12 h generally, treatment time of patients with cerebral edema, liver and kidney syndrome, was prolonged up to 24 h. Results Among patients with severe liver disease treated with CAPS, 2 cases died, 1 case of late MODS with chronic severe hepatitis, the other of immunosuppression induced fibrosing cholestatic hepatitis and liver failure after renal transplantation, survival rate was 57.1%. Conclusion Nurses should make the appropriate psychological care for patients with different mental states, and try to make patients' families understand and cooperate, making its treatment smoothly.
引文
[1]Novelli G,Rossi M,Pretagostini MF,et al.One hundred sixteen cases of acute liver failure treated with MARS[J].Transplatation Proceeding,2005,37:2557-2559.
[2]Braun C,Birck R,Singer MV,et al.Life-threatening intoxi-cation with methylene bis(thiocyanate):clinical pictureand pitfalls.A case report[J].BMC Emergency Medicine,2006,11:5.
[3]Saliba F.The Molecular Adsorbent Recirculating System(MARS(R)in the intensive care unit:a rescue therapy for atients with hepatic failure[J].Critical Care,2006,10(1):118.
[4]郭利民.分子吸附再循环系统治疗重症肝病的护理[J].透析与人工器官,2004,15(1):33-36.
[2]Braun C,Birck R,Singer MV,et al.Life-threatening intoxi-cation with methylene bis(thiocyanate):clinical pictureand pitfalls.A case report[J].BMC Emergency Medicine,2006,11:5.
[3]Saliba F.The Molecular Adsorbent Recirculating System(MARS(R)in the intensive care unit:a rescue therapy for atients with hepatic failure[J].Critical Care,2006,10(1):118.
[4]郭利民.分子吸附再循环系统治疗重症肝病的护理[J].透析与人工器官,2004,15(1):33-36.