摘要
目的 探析对重症爆发性心肌炎进行 ECMO与 CRRT联合治疗过程中实施综合护理的效果。方法 自2022年12月我院开始收集重症爆发性心肌炎的病例资料，至2023年12月共纳入66例，均采取ECMO联合CRRT治疗，平均分成2组。参照组干预方法为常规护理；实验组干预方法为综合护理。对比两组护理干预的依从性、满意度以及并发症等情况。结果 实验组综合护理的依从率为93.94%较参照组常规护理的75.76%显著偏高（P<0.05）。实验组在各方面的护理满意度评分较参照组显著偏高（P<0.05）。实验组在综合护理干预过程中并发症的发生率6.06%较参照组的15.15%显著偏高（P<0.05）。结论 对重症爆发性心肌炎进行 ECMO与 CRRT联合治疗过程中实施综合护理，能有效提高临床护理的依从性，促进患者的遵医行为，使护理满意度全面提升，且并发症的发生率明显下降，综合护理效果更佳，在临床实践中的推广价值较高。
关键词： 综合护理；ECMO；CRRT；重症爆发性心肌炎；效果
Abstract
Objective To explore the effect of implementing comprehensive nursing during the combined treatment of ECMO and CRRT for severe explosive myocarditis. Methods Since December 2022, our hospital has been collecting case data of severe explosive myocarditis. By December 2023, a total of 66 cases were included, all of which were treated with ECMO combined with CRRT, and were evenly divided into two groups. The intervention method for the reference group is routine nursing; The intervention method for the experimental group is comprehensive nursing. Compare the compliance, satisfaction, and complications of two nursing interventions. Results The compliance rate of comprehensive nursing in the experimental group was 93.94%, which was significantly higher than that of routine nursing in the reference group at 75.76% (P<0.05). The nursing satisfaction scores of the experimental group were significantly higher than those of the control group in all aspects (P<0.05). The incidence of complications in the comprehensive nursing intervention process in the experimental group was 6.06%, which was significantly higher than the control group's 15.15% (P<0.05). Conclusion Implementing comprehensive nursing during the combined treatment of ECMO and CRRT for severe explosive myocarditis can effectively improve clinical nursing compliance, promote patient compliance, comprehensively improve nursing satisfaction, and significantly reduce the incidence of complications. The comprehensive nursing effect is better, and it has high promotion value in clinical practice.
Key words： Comprehensive nursing; ECMO; CRRT; Severe explosive myocarditis; Effect
参考文献 References
[1] 郭晶岚.综合护理在急性重症病毒性心肌炎合并心力衰竭及心源性休克的实施效果[J].心血管病防治知识,2020, 10(6):74-75.
[2] 龙洁莹,霍燕嫦,刘伟娟.循证护理模式在主动脉内球囊反搏治疗急性重症病毒性心肌炎中的临床护理效果[J].中国实用医药,2021,11(5):236-237.
[3] 周小莎,孙亚妮.暴发性心肌炎患者应用体外膜肺氧合治疗的护理经验[J/CD].中华肺部疾病杂志(电子版),2020, 13(4):571-572.
[4] 李云. V-A ECMO 联合 CRRT 治疗急性爆发性心肌炎合并多脏器功能衰竭患者的护理[J].齐鲁护理杂志,2020, 26(7): 118-120.
[5] 刘慧,李付华,张苇,等. ECMO 联合 IABP 及 CRRT 治疗重症暴发性心肌炎患者的护理体会[J].河南外科学杂志,2019,25(6):164-166.
[6] 吴会军,鄢建军,童辉,等.体外膜肺氧合联合高容量血液滤过治疗成人暴发性心肌炎病人的护理[J].全科护理,2022,20(9):1214-1216.
[7] 李晓丽.程序化护理干预在小儿重症病毒性脑炎合并心肌炎中应用观察[J].中西医结合心血管病电子杂志,2019, 4(31):5-6.
[8] 王淑芹,万娜,张煜,等.体外膜肺氧合联合主动脉内球囊反搏救治暴发性心肌炎患者的护理[J].中华急危重症护理杂志,2020,1(5):451-452.
[9] 翁晓丽,林君卿.循证护理模式在主动脉内球囊反搏治疗急性重症病毒性心肌炎中的临床护理效果[J].心血管病防治知识(学术版),2019，31(7):77-79.
[10] 顾翠生,徐慧,孙小燕.综合护理在 ECMO 联合 CRRT 对重症心肌炎合并呼吸衰竭患者的应用效果[J].中西医结合护理(中英文),2022,8(1):127-128.