重症患者连续性肾脏替代治疗的专科护理实施方案构建与效果评价

Development and Effect Evaluation of a Specialized Nursing Implementation Protocol for Continuous Renal Replacement Therapy in Critically Ill Patients

摘要: 目的：构建重症患者连续性肾脏替代治疗(CRRT)的专科护理实施方案，并评价其临床应用效果。方法：采用文献回顾、专家咨询和临床实践相结合的方法，构建CRRT专科护理实施方案。选择2022年6月至2024年3月在我院重症医学科接受CRRT治疗的180例患者作为研究对象，按照时间顺序分为对照组(n = 90，实施常规护理)和干预组(n = 90，实施专科护理方案)。比较两组患者的治疗效果、并发症发生率、护理满意度等指标。结果：干预组患者的滤器使用寿命显著延长(68.5 ± 12.3 h vs 52.4 ± 10.7 h, P < 0.05)，血管通路相关并发症发生率显著降低(8.9% vs 21.1%, P < 0.05)，护理满意度显著提高(94.4% vs 86.7%, P < 0.05)。两组患者在28天病死率方面无统计学差异(P > 0.05)。结论：构建的CRRT专科护理实施方案能够有效提高护理质量，延长滤器使用寿命，降低并发症发生率，提高患者满意度，值得临床推广应用。

Abstract: Objective: To develop a specialized nursing implementation protocol for continuous renal replacement therapy (CRRT) in critically ill patients and evaluate its clinical application effects. Methods: The CRRT specialized nursing implementation protocol was developed using a combination of literature review, expert consultation, and clinical practice. A total of 180 patients who underwent CRRT in the intensive care unit of our hospital from June 2022 to March 2024 were selected as the study subjects. They were divided into a control group (n = 90, receiving routine care) and an intervention group (n = 90, receiving the specialized nursing protocol) based on the time sequence. Treatment outcomes, complication rates, and nursing satisfaction were compared between the two groups. Results: The filter lifespan was significantly longer in the intervention group (68.5 ± 12.3 h vs. 52.4 ± 10.7 h, P < 0.05), the incidence of vascular access-related complications was significantly lower (8.9% vs. 21.1%, P < 0.05), and nursing satisfaction was significantly higher (94.4% vs. 86.7%, P < 0.05). There was no statistically significant difference in the 28-day mortality rate between the two groups (P > 0.05). Conclusion: The developed specialized nursing implementation protocol for CRRT can effectively improve nursing quality, prolong filter lifespan, reduce complication rates, and enhance patient satisfaction, making it worthy of clinical promotion and application.