连续性肾替代治疗在Stanford A型主动脉夹层术后并发急性肾损伤中的护理

目的总结连续性肾替代治疗(CRRT)在Stanford A型急性主动脉夹层术后发生急性肾损伤(AKI)的护理经验。方法收集在本院治疗的Stanford A型急性主动脉夹层术后发生AKI的患者16例,采用连续性静脉-静脉血液滤过(CVVH)疗法,行床旁CRRT治疗,监测肾功能、电解质、中心静脉压、p(O_2)/FiO_2,并从CRRT管路、心理、皮肤、饮食等多方面进行护理。结果 1例合并感染及多器官功能衰竭死亡,1例死于脑梗死,其余14例行CRRT治疗后肾功能恢复,且均治愈出院。结论Stanford A型急性主动脉夹层术后发生AKI患者死亡率高,早期行CRRT治疗可有效的减少死亡率,术后护理及全面的病情观察及判断有利于改善预后。

Nursing of Stanford type A aortic dissection surgery complicating acute kidney injury in patients with continuous renal replacement therapy

Objective To summarize nursing experiences of continuous renal replacement therapy (CRRT) in patients after aortic dissection surgery complicating acute kidney injury (AKI).Methods A total of 16 patients with AKI after aortic dissection surgery were enrolled in our hospital.All patients were underwent CRRT by continuous vein-vein hemofiltrations(CVVH), and renal function, electrolyte, central vein pressure, p(O2)/FiO2 were monitored, and nursed in CRRT catheters, psychology, skin and diet.Results Among them, one patient died of infection and multiple organ failure, one died of cerebral infarction, and the other 14 recovered and discharged with improved renal function by CRRT.Conclusion There is a higher mortality rate in patients with AKI after aortic dissection surgery.Early CRRT and carefully comprehensive nursing may be beneficial for improving prognosis.