人工肝支持系统治疗蜂蜇伤导致器官功能受损的护理对策探讨-现代医学

人工肝支持系统治疗蜂蜇伤导致器官功能受损的护理对策探讨

作者：何静

单位：达州市中心医院重症医学科, 四川达州 635000

分类号：R473.5

出版年·卷·期（页码）：2019·47·第二期（236-239）

摘要：

目的：探讨人工肝支持系统（ALSS）治疗蜂蜇伤导致肝受损患者高危风险的护理对策。方法：分析近2年我院ALSS治疗蜂蜇伤导致肝受损患者的高危风险情况及护理对策。结果：（1）和非肝受损组对比，肝受损组年龄、病死率、MODS发生率、SOFA评分、WBC、K⁺、cTnI、CK-MB、PT、APTT、BUN、SCr、ALT、AST明显更高，蜂蜇伤至入院时间和住院时间明显更长，同时Hb、CO₂明显更低，数据差异明显，有统计学意义（P<0.05）。（2）蜂蜇伤导致肝受损的高危因素包括高龄超过50岁、蜂蜇伤至入院时间超过8h、WBC低于2 020×10⁹·L^-1、Hb低于110 g·L^-1。（3）和A组对比，B组治疗后APACHEⅡ评分明显更低，数据差异明显，P<0.05；和治疗前对比，两组治疗后APACHEⅡ评分明显降低（P<0.05）。结论：蜂蜇伤导致肝受损患者病情危急，人工肝支持系统具有明显治疗效果，针对性护理有利于提高人工肝支持系统的治疗效果，值得推广。

Objective:To study nursing countermeasures for the impairment of organ function by treating bee stings with artificial liver support system.Methods:Analysis of nearly 2 years our ALSS treatment bee sting led to the risk of liver damage in patients with high-risk and nursing countermeasures.Results:(1)Liverdamage, age of the liver damage group, mortality, the incidence of MODS, SOFA score, the WBC, K⁺, cTnI, CK-MB, PT, APTT, BUN, SCr, ALT, AST were significantly higher, time from bee sting to admissionand hospital staywere obviously longer, Hb and CO₂ were significantly lower at the same time, with a statistical significance, P<0.05).(2) Bee stingcausing liver damage risk factors included age of over 50, admission to hospital bee sting longer than 8 h, WBC lower than 2 020×10⁹·L^-1, Hbless than 110 g·L^-1.(3) Compared with group A, APACHEⅡ score in group B was significantly lower after treatment, the difference was significant, P<0.05; And compared before treatment, APACHEⅡ score was significantly lower after treatment in both groups, with a significant difference, P<0.05.Conclusion:The patients with liver injury caused by bee stings are in critical condition. Artificial liver support system has obvious therapeutic effect. Targeted nursing is helpful to improve the therapeutic effect of artificial liver support system and is worth promoting.

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