目标导向超声方案预防ICU患者连续性肾脏替代治疗非计划性下机的效果研究

doi:10.3761/j.issn.2096-7446.2026.10.001

摘要/Abstract

摘要：

目的探讨目标导向的超声方案在预防ICU患者连续性肾脏替代治疗（continuous renal replacement therapy，CRRT）非计划性下机中的应用效果。方法通过文献回顾和专家咨询构建超声方案，连续纳入2024年1月—2025年6月于贵州医科大学附属医院ICU接受CRRT、符合纳入与排除标准的120例患者为研究对象；全部样本收集完成后，采用随机数字表法分为试验组和对照组，每组各60例。试验组实施目标导向的超声方案，包括下机风险分层评估、针对性监测和干预措施等；对照组采用常规CRRT管理。比较两组患者非计划性下机发生率、滤器使用时间、液体平衡精准度及ICU住院时长。结果在CRRT过程中，试验组的非计划性下机发生率为11.67%，显著低于对照组的28.33%（P<0.05）。试验组滤器的平均使用时长、液体平衡达标率均高于对照组，而ICU平均住院天数低于对照组，差异均具有统计学意义（P<0.05）。结论目标导向的超声方案在CRRT过程中能够有效降低非计划性下机风险，延长滤器使用寿命，优化液体管理，为改善ICU患者临床预后提供了参考。

关键词: 重症超声, 连续性肾脏替代治疗, 非计划性下机, 液体管理, 危重症患者

Abstract:

Objective To explore the application effect of a goal-oriented ultrasound protocol in preventing unplanned discontinuation of continuous renal replacement therapy（CRRT） among patients in the intensive care unit （ICU）. Methods The goal-oriented ultrasound protocol was developed through literature review and expert consultation. A total of 120 eligible patients receiving CRRT in the ICU of Affiliated Hospital of Guizhou Medical University from January 2024 to June 2025 were consecutively enrolled. After all subjects were recruited，patients were randomly assigned to the experimental group and control group by random number table，with 60 cases in each group.The control group received conventional CRRT management，while the experimental group received a goal-oriented ultrasound protocol，including risk stratification assessment prior to discontinuation，targeted monitoring，and intervention measures. The incidence of unplanned discontinuation，filter usage duration，precision of fluid balance，and ICU hospitalization duration were compared between the two groups. Results The incidence of unplanned CRRT discontinuation in the experimental group was 11.67%，which was significantly lower than 28.33% in the control group（P<0.05）. The average filter service time and the compliance rate of fluid balance in the experimental group were significantly higher，while the average length of ICU stay was significantly shorter than those in the control group（P<0.05）. Conclusion The goal-oriented ultrasound protocol can effectively reduce the risk of unplanned CRRT discontinuation，prolong filter service life，optimize fluid management，and provide a reference for improving clinical prognosis of ICU critically ill patients.

Key words: Critical Care Ultrasound, Continuous Renal Replacement Therapy, Unplanned CRRT Discontinuation, Fluid Management, Critically Ill Patients

贾本涛, 徐楠, 董天菊, 黎张双子, 谭万林, 罗尚荣, 乔国瑾, 皮建华, 王梅. 目标导向超声方案预防ICU患者连续性肾脏替代治疗非计划性下机的效果研究[J]. 中华急危重症护理杂志, 2026, 7(10): 1157-1163.

JIA Bentao, XU Nan, DONG Tianju, LI Zhangshuangzi, TAN Wanlin, LUO Shangrong, QIAO Guojin, PI Jianhua, WANG Mei. Effect of goal-oriented ultrasound protocol on preventing unplanned discontinuation of continuous renal replacement therapy in ICU patients[J]. Chinese Journal of Emergency and Critical Care Nursing, 2026, 7(10): 1157-1163.

图/表 3

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