李砾 刘燕红 梁少冰

[摘要]目的 探讨集束化护理在行连续性肾脏替代治疗的老年危重症患者中的应用效果。方法 选取2017年1～12月在我院行连续性肾脏替代治疗的80例老年危重症患者作为研究对象，根据随机数字表法分为常规护理组和集束化护理组，每组各40例。比较两组患者治疗过程中常见并发症（压疮、感染、深静脉血栓和水电解质紊乱）的发生情况以及患者的治疗依从性。结果 集束化护理组患者治疗过程中并发症（压疮、感染、深静脉血栓和水电解质紊乱）的发生率均低于常规护理组（P<0.05）；集束化护理组患者的治疗总依从率（87.50%）显著高于常规护理组（55.00%）（P<0.05）。结论 对行连续性肾脏替代治疗治疗的老年危重症患者而言，集束化护理能显著改善治疗过程中的并发症，提高患者的治疗依从性，值得推广。

[关键词]连续性肾脏替代治疗；集束化护理；老年危重症；并发症；治疗依从性

[中图分类号] R587.2 [文献标识码] A [文章编号] 1674-4721（2018）11（b）-0209-03

[Abstract] Objective To explore the application effect of cluster nursing in old critically ill patients with continuous renal replacement therapy. Methods From January to December 2017， A total of 80 old critically ill patients treated with continuous renal replacement therapy in our hospital were selected as the subjects， and divided into common nursing group and cluster nursing group according to the random number table method， with 40 cases in each group. The complication （pressure sores， infection， deep venous thrombosis and disturbance of water and electrolyte） and treatment compliance during the treatment in the two group were compared. Results The occurance of pressure sores， infection， deep venous thrombosis and disturbance of water and electrolyte in cluster nursing group were lower than those in common nursing group （P<0.05）. The total compliance rate of treatment in cluster nursing group was 87.50%， significantly higher than that in the common nursing group （55.00%） （P<0.05）. Conclusion Cluster nursing can decrease the complication and increase the treatment compliance of continuous renal replacement therapy in old critically ill patients， it is worth promoting clinically.

[Key words] CRRT； Cluster nursing； Old critically ill patients； Complication； Treatment compliance

连续性肾脏替代治疗（continuous renal replacement therapy，CRRT）作為如今重症监护室常用的一种血液净化方式，对危重症患者起着有效的脏器功能支持，在重症患者生命维持中凸显重要价值。老年危重患者的身体素质往往较差，长期治疗会导致严重的治疗并发症[1]，且由于危重病情常使患者身心俱创，治疗依从性往往不理想，因此对老年危重患者而言，该治疗方式对护理要求十分高。然而，当前的常规护理方法存在很多缺陷，往往不能对行连续性肾脏替代治疗的老年危重患者起到有效的护理效果。研究显示，集束化护理依据循证医学而实施，具有全面、连续、个体化等优点，已在多个领域良好应用[2-3]。本文旨在探讨集束化护理在行连续性肾脏替代治疗的老年危重症患者中的应用效果，现报道如下。……