连续性肾脏替代治疗中滤器后加热法对患者体温的影响

目的探讨连续性肾脏替代治疗(CRRT)中滤器后加热法对患者体温的影响。方法将60例行CRRT治疗的患者随机分为对照组和观察组各30例,对照组按常规将加温装置连接到置换液的管路上,观察组将加温装置连接到滤器后静脉端血液回输管路上。两组均于CRRT治疗开始3h、6h、12h时测量患者体温及深静脉置管的动、静脉端的血液温度;比较两组治疗前后溶血反应相关检验结果。结果在CRRT治疗不同时段,两组深静脉置管的动、静脉端的血液温度比较,干预主效应均P<0.05;治疗12h时观察组低体温发生率显著低于对照组(P<0.05)。两组治疗前后溶血反应相关检验结果比较,差异无统计学意义(均P>0.05)。结论滤器后加热血液回输管路的方式可安全有效地补充CRRT治疗中循环热量,降低CRRT治疗中低体温发生率。

Effect of post-filter heating on body temperature of patients receiving continuous renal replacement therapy

Objective To investigate the effect of post-filter heating on body temperature of patients receiving continuous renal replacement therapy(CRRT).Methods A total of 60 patients treated with CRRT were divided into a control group(n=30) and an observation group(n=30) randomly.In the control group,a heating device was connected to a tubing system responsible for fluid substitution.In the observation group,the same heating device was connected to post-filter return tube through which blood cycled back to patients.Body temperature and the temperature of blood at arterial and venous ends of deep venous catheterization were measured at 3 h,6 h and 12 h of CRRT.Indicators of hemolysis were tested before and after the treatment. Results The group effect between the 2 groups in arterial and venous blood temperature were significant at varied time points of CRRT(P<0.05 for all);at 12 h of CRRT,the incidence of hypothermia in the observation group was lower than the control group(P<0.05).No significant differences were found in lab test results of hemolysis-related indicators(P>0.05 for all).Conclusion Heating of post-filter return tube in CRRT treatment can reduce heat loss,and decrease the incidence of hypothermia.