目的 探讨ICU连续性肾脏替代治疗(continuous renal replacement therapy,CRRT)患者开展早期活动对安全性的影响。方法 经医院伦理委员会审核通过,CRRT患者或家属自愿签署统一的知情同意书。通过计算机随机数字表法将18例CRRT患者按1∶1随机分为试验组与对照组,每组9例。对照组给予常规治疗和护理,试验组在CRRT上机期间进行主被动关节活动,比较两组的活动前、活动中及活动后CRRT压力参数(动脉压、静脉压、滤前压、跨膜压)和生命体征(血压、心率、呼吸频率、血氧饱和度),比较两组不良事件发生情况。结果 18例患者均完成研究,试验组完成41例次早期活动,对照组记录36例次数据。两组CRRT压力参数在不同时间点(0、15、30 min)比较差异无统计学意义。试验组30 min时动脉压[(-80.41±31.91)mmHg]与0 min时[(-76.54±33.59)mmHg]比较,差异有统计学意义(P=0.005);15 min时静脉压[(57.05±20.99)mmHg]与0 min时[(54.80±22.82)mmHg]比较,差异有统计学意义(P=0.024);30 min时静脉压[(59.85±21.73)mmHg]与0 min时比较,差异有统计学意义(P=0.000);30 min时跨膜压[(84.39±25.80)mmHg]与0 min时[(80.78±27.69)mmHg]比较,差异有统计学意义(P=0.036)。两组生命体征在不同时间点(0、15、30 min)比较,差异均无统计学意义,不同时间点与0 min比较差异均无统计学意义(P＞0.05)。两组不良事件发生率比较差异无统计学意义。结论 ICU连续性肾脏替代治疗患者开展早期活动是安全的。
Abstract
Objective To investigate the effect of early mobilities on the safety in ICU patients with continuous renal replacement therapy (CRRT). Methods Eighteen patients with CRRT were randomly divided into experimental group (n=9) and control group (n=9) by computer random number table method. The control group was given routine treatment and nursing, while the experimental group performed active and passive range of motion during CRRT on-machine.The CRRT pressure parameters (arterial pressure PA, venous pressure PV, prefiltration pressure PBE, and Transmembrane pressure TMP) and vital signs (blood pressure BP, heart rate HR, respiratory rate RR, blood oxygen saturation SpO2) were compared before (0 min), during (15 min) and after (30 min) the mobility, and the occurrence of adverse events in the two groups were also compared. Results All the patients completed the study, and the experimental group completed 41 times of early mobilities, while the control group were recorded 36 times. There was no significant difference in CRRT pressure parameters between the two groups at different time points (0, 15, 30 min) (P>0.05). There was statistically significant difference in PA at 30 min[(-80.41±31.91)mmHg] and at 0 min[(-76.54±33.59)mmHg] in the experimental group (P=0.005); PV at 15 min [(57.05±20.99)mmHg] and at 0 min[(54.80±22.82)mmHg], the difference was statistically significant (P=0.024); the PV at 30 min [(59.85±21.73)mmHg] was significantly different from that at 0 min (P=0.000). There was statistically significant difference between TMP at 30 min[(84.39±25.80)mmHg] and TMP at 0 min[(80.78±27.69)mmHg] (P=0.036). There was no significant difference in vital signs between the two groups at different time points (0, 15, 30 min), and there was no significant difference between different time points and 0 min. There was no significant difference in adverse events between the two groups. Conclusion It is safe to carry out early mobilities in ICU patients with c CRRT.
关键词
ICU /
连续性肾脏替代治疗 /
早期活动 /
安全性
Key words
ICU /
continuous renal replacement therapy /
early mobility /
safety
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基金
首都临床诊疗技术研究及转化应用项目(Z201100005520009)
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