连续性血液净化治疗蜂蜇伤致急性肾功能衰竭的临床观察与护理体会_West China Medical Journal

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陈懿 , 秦敏 , 洪芸

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Keywords：

连续性血液净化; 蜂蜇伤; 急性肾功能衰竭; 护理

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目的:观察连续性血液净化(CBP)治疗蜂蜇伤致急性肾功能衰竭(ARF)的疗效分析及护理体会。方法:回顾2005～2007 年蜂蜇伤致急性肾功能衰竭17例,采用连续性静静脉血液滤过(CVVH)方式进行治疗,从存活率、治愈率及肾功能恢复时间等多个方面比较CVVH治疗蜂蜇伤致肾功能衰竭是否具有优越性,从护理角度总结CVVH过程中护理的经验和作用。结果:患者治疗前APACHE评分差异无统计学意义。（1）CVVH:17 例患者早期行持续性静静脉血液滤过,CVVH治疗1～4次,总治疗时间(38.6±14.8)h,情况稳定后给予间歇性血液透析(间歇性血液透析)治疗。16例患者好转出院,1例患者死亡。⑵在CVVH治疗过程中严密监测生命体征、液体管理、预防出血、预防感染、血管通路的护理是CVVH治疗护理重点。结论:早期CVVH可能有利于患者受损器官功能的恢复,缩短患者的住院时间。在CVVH治疗过程良好的护理和密切的观察是保证CVVH顺利进行的重要保障。

Citation： 陈懿,秦敏,洪芸. 连续性血液净化治疗蜂蜇伤致急性肾功能衰竭的临床观察与护理体会. West China Medical Journal, 2009, 24(6): 1526-1564. doi: Copy

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1. RABINDRANATH K, ADAMS J, MACLEOD AM, et al.Intermittent versus continuous renal replacement therapy for acute renal failure in adults[J].The Cochrane Library,2007,Issue 4.
2. CHRISTOPHE V, CHRISTOPHE C, ALAIN CH,et al.Continuous endogenous haemodiafi alteration versus intermittent haemodialysis for acute renal failure in patients with multipleorgan dysfunction syndrome: a multicentre randomized trial[J].Lancet, 2006,368:379-385.
3. 王健,肖明英.严重蜂蜇伤12例预后相关因素分析[J].中华内科杂志,2005,44(3):225-226.
4. GRISOTTO LS,MENDES GE,CASTRO I,et al. Mechanisms of bee venominduced acute renal failure[J].2006,48(1):44-54.
5. TUNGET CL,CLARK RF.Invasion of the killer bees.Separating fact from fiction[J]. Post grad Med,1993,94:9294,9798,101-102.
6. 何小平,吴萍,刘林.血液净化治疗蜂毒中毒致急性肾功能衰竭37例分析[J].第三军医大学学报,2002,26(9):816-819.

West China Medical Journal

连续性血液净化治疗蜂蜇伤致急性肾功能衰竭的临床观察与护理体会

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