CRRT治疗中不同碳酸氢钠输注方式对危重症患者容量控制的研究
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摘要
目的研究连续性肾脏替代(CRRT)治疗中不同碳酸氢钠输注方式对危重症患者容量控制的影响。方法 60例行CRRT治疗的危重症患者,按照碳酸氢钠输注方式不同分为实验组与对照组,各30例。实验组为碳酸氢钠溶液加入置换液中,钙离子从静脉壶输入;对照组将碳酸氢钠溶液从静脉壶段输注,钙离子加入置换液中。于治疗前、治疗后12 h及24 h、治疗结束后测定两组患者的血浆B型尿钠肽(BNP)、C反应蛋白(CRP)水平,并进行组间比较。结果两组患者治疗前的BNP、CRP水平比较差异均无统计学意义(P>0.05);治疗后12 h、24 h及治疗结束后,实验组的BNP及CRP水平均低于对照组,差异有统计学意义(t=19.438、46.900、89.517及11.865、11.301、22.074,P<0.05)。结论 CRRT治疗中不同碳酸氢钠输注方式对危重症患者容量控制具有一定的影响,采取碳酸氢钠溶液加入置换液中、钙离子从静脉壶输入的方式,可提升容量控制质量,值得临床推行。
Objective To research the influence of volume control of different Sodium Bicarbonate infusion methods in critically ill patients during continuous renal replacement therapy(CRRT) treatment. Methods A total of 60 critically ill patients with CRRT treatment were divided into experimental group and control group according to different Sodium Bicarbonate infusion methods, 30 cases in each group. In the experimental group, Sodium Bicarbonate solution was added to the replacement solution, and calcium ion was injected from the venous kettle. In the control group, Sodium Bicarbonate solution was injected from the venous kettle, and calcium ion was added to the replacement solution. The levels of plasma B-type natriuretic peptide(BNP) and C-reactive protein(CRP) were measured before treatment, 12 hours, 24 hours after treatment and end of treatment in the two groups, then comparisons were made between the two groups. Results There were no significant differences in the levels of BNP and CRP between the two groups before treatment(P>0.05). After 12 hours, 24 hours of treatment and end of treatment, the levels of BNP and CRP in the experimental group were significantly lower than those in the control group, the differences were statistically significant(t=19.438, 46.900, 89.517 and 11.865, 11.301, 22.074, P<0.05). Conclusion Different infusion methods of Sodium Bicarbonate during CRRT treatment have certain influence on the volume control of critically ill patients. The volume control quality can be improved by adding Sodium Bicarbonate solution into the replacement solution and calcium ion into the venous kettle,it is worthy of clinical application.
Objective To research the influence of volume control of different Sodium Bicarbonate infusion methods in critically ill patients during continuous renal replacement therapy(CRRT) treatment. Methods A total of 60 critically ill patients with CRRT treatment were divided into experimental group and control group according to different Sodium Bicarbonate infusion methods, 30 cases in each group. In the experimental group, Sodium Bicarbonate solution was added to the replacement solution, and calcium ion was injected from the venous kettle. In the control group, Sodium Bicarbonate solution was injected from the venous kettle, and calcium ion was added to the replacement solution. The levels of plasma B-type natriuretic peptide(BNP) and C-reactive protein(CRP) were measured before treatment, 12 hours, 24 hours after treatment and end of treatment in the two groups, then comparisons were made between the two groups. Results There were no significant differences in the levels of BNP and CRP between the two groups before treatment(P>0.05). After 12 hours, 24 hours of treatment and end of treatment, the levels of BNP and CRP in the experimental group were significantly lower than those in the control group, the differences were statistically significant(t=19.438, 46.900, 89.517 and 11.865, 11.301, 22.074, P<0.05). Conclusion Different infusion methods of Sodium Bicarbonate during CRRT treatment have certain influence on the volume control of critically ill patients. The volume control quality can be improved by adding Sodium Bicarbonate solution into the replacement solution and calcium ion into the venous kettle,it is worthy of clinical application.
引文
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[2]高亚梅,郑燕,陶燕燕.护理干预在连续性肾脏替代治疗的ICU危重症患者中的应用效果.实用临床医药杂志,2018,4(2):34-35.
[3]蔡秀芬,周锦华,何美娜.护理干预对ICU行连续性肾脏替代治疗危重症患者心血管并发症的影响.中国医药指南,2017,15(26):237-238.
[4]余绍驰,刘欢,莫松,等.ICU床旁连续性肾替代治疗重症感染患者的临床疗效.医疗装备,2017,30(10):98-99.
[5]沈威,吴克艳.连续性肾脏替代治疗对急性肾损伤重症患者肿瘤坏死因子-α与病死率的影响.中国中西医结合急救杂志,2016,23(1):85-88.
[6]陈玉红,郑明,李斌,等.不同连续性肾脏替代治疗模式及其剂量对脓毒症合并急性肾损伤患者溶质清除效果的研究.中国全科医学,2016,19(18):2145-2150.