【摘要】目的探讨实时动态体质量监测联合无创血流动力学监测在连续性血液净化(continuous blood purification CBP)治疗护理中的指导作用。方法对行CBP 治疗的患者100 人，随机分为2 组，每组50 人。2 组患者于治疗前和治疗后均行无创血流动力学监测。对照组于CBP 治疗前和治疗结束后各测1 次体质量；实验组使用称重床于CBP 治疗前一直到治疗后给予实时动态体质量监测，每小时记录1次数据并及时纠正偏差，统计分析2 组患者容量及体质量达标率和并发症的发生率。结果容量状态情况：与对照组相比，实验组男性胸液含量(thoracic nuid content, TFC)、女性TFC、中心静脉压(central venous pressure，CVP) 及平均动脉压(mean arterial pressure，MAP) 显著降低(t 值分别为 4.938，3.621，4.292，5.539；P 值分别＜0.001，＜0.001，＜0.001，＜0.001)；与对照组相比，实验组体质量达标率明显升高(χ2=4.001，P=0.046)；与对照组相比，实验组并发症发生率显著降低(χ2=4.496，P=0.036)。结论在CBP 治疗中运用实时动态体质量监测联合无创血流动力学监测，便于观察患者容量状态、及时纠正偏差、准确调整超滤量, 在指导危重症患者治疗护理方面均具有指导意义。
【Abstract】Objective To investigate the guiding role of real- time dynamic body weight monitoring combined with non- invasive hemodynamic monitoring in nursing care of patients undergoing continuous blood purification (CBP) treatment. Methods A total of 100 patients treated with CBP and with noninvasive hemodynamic monitoring before and after the treatment were enrolled in this study. They were randomly divided into two groups. In control group (n=50 cases), body weight was measured before and after CBP; in experiment group (n=50 cases), body weight was measured every hour before, during and after CBP by using a weighing bed, and the deviations were corrected. The compliance rates of volume load and body weight and the incidence of complications were compared between the two groups. Results For volume status, thoracic fluid content (TFC) in males, TFC in females, central venous pressure (CVP) and mean arterial pressure (MAP) were significantly lower in the experiment group as compared those in the control group (t=4.938, 3.621, 4.292 and 5.539 respectively; P＜0.001); the compliance rate of body weight was higher (χ2= 4.001, P=0.046) and the incidence of complications was lower (χ2=4.496, P=0.036) in the experiment group as compared those in the control group. Conclusion The use of real-time dynamic weight detection combined with non-invasive hemodynamic monitoring during CBP can easily observe the patients’volume status, correct the deviation immediately, and adjust the ultrafiltration volume accurately, thus useful for the performance of CBP treatment and nursing protocols in critically ill patients.
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