血液净化治疗在148例急危重症患儿中的应用及护理

Application of blood purification in the treatment of 148 children with acute and critical illness and its nursing care

摘要:

目的：探讨不同的血液净化模式在治疗婴幼儿急危重症中的应用，总结护理经验和体会，为儿科临床工作提供借鉴。方法：对2009年1月-2011年12月在我院儿童血液净化中心接受血液净化治疗的148例患儿的临床资料进行回顾性分析，包括患儿的原发疾病种类、血液净化模式、临床疗效、相关并发症的治疗和护理等。结果：本组148例患儿共进行血液净化336次，死亡5例，2例为先天性心脏病术后并发肾功能不全，2例为脓毒血症并发感染性休克、炎症反应导致多器官功能衰竭，1例为流行性脑脊髓膜炎并发肾功能不全，死亡原因与血液净化无直接关系；其余患儿均痊愈出院。结论：血液净化模式的选择、参数的设置、管路的良好护理、抗凝剂的合理使用及必要的管路预充等是儿童血液净化技术的重要组成部分，该项技术的开展和推广，有利于提高婴幼儿危急重症的治疗水平。

Abstract:

Objective：To explore the application of different blood purification modes in the treatment of children with acute and criti－cal illness and to summarize the experiences in order to provide references for pediatric clinical work. Methods：Clinical data of 148 children underwent blood purification treatment from January 2009 to December 2011 in our hospital were retrospectively analyzed including primary types of diseases，blood purification mode，clinical efficacy，treatment and care for related complications，etc. Results：All 148 patients underwent blood purification treatment for 336 times. Five cases of death，including 2 cases of congenital heart disease complicated with renal failure，2 cases of sepsis complicated with septic shock and multiple organ failure，1 case of epidemic cere－brospinal meningitis complicated with renal insufficiency were observed. Cause of death and blood purification had no direct relation－ship. The rest children were cured and discharged. Conclusions：Blood purification mode selection，parameter setting，good care of the pipeline，rational use of anticoagulants and necessary pre-charge of piping are the important parts of children blood purification tech－nology. Application and promotion of the technology helps to improve the treatment for children with acute and critical illness.