摘要
体外膜肺氧合（ECMO）作为重症患者生命支持的关键技术，其抗凝管理至关重要，但相关并发症的发生率较高，严重影响治疗效果。本研究旨在探讨基于预见性护理的ECMO抗凝管理策略，以降低并发症发生率并优化患者预后。研究选取某三甲医院2021年至2023年间接受ECMO治疗的80例患者，随机分为对照组和干预组，各40例。对照组采用常规抗凝护理，干预组则实施基于风险评估与动态监测的预见性护理方案。结果显示，干预组患者的出血、血栓等并发症发生率显著低于对照组（P0.05），同时ACT和APTT指标控制更为稳定。此外，干预组患者机械通气时间及ICU住院时间均明显缩短。本研究创新性地将预见性护理理念融入ECMO抗凝管理，通过精准的风险评估与个体化干预措施，有效提升了护理质量，为临床实践提供了新思路。研究表明，预见性护理在ECMO抗凝管理中具有重要应用价值，可作为优化患者结局的有效手段。关键词：体外膜肺氧合；预见性护理；抗凝管理；并发症发生率；患者预后
Predictive Nursing Care for Complications in ECMO Anticoagulation Management
Abstract
Extracorporeal membrane oxygenation (ECMO) serves as a critical life-support technology for critically ill patients, and its anticoagulation management is of paramount importance. However, the incidence of related complications remains high, significantly affecting treatment outcomes. This study aimed to investigate an anticoagulation management strategy for ECMO based on predictive nursing care to reduce complication rates and optimize patient prognosis. A total of 80 patients who received ECMO treatment at a tertiary hospital between 2021 and 2023 were selected and randomly divided into a control group and an intervention group, with 40 patients in each group. The control group received conventional anticoagulation care, while the intervention group was managed with a predictive nursing protocol based on risk assessment and dynamic monitoring. Results indicated that the incidence of complications such as bleeding and thrombosis was significantly lower in the intervention group compared to the control group (P0.05), and the ACT and APTT indicators were more stably controlled. Additionally, both mechanical ventilation duration and ICU length of stay were markedly reduced in the intervention group. This study innovatively integrated the concept of predictive nursing into ECMO anticoagulation management, enhancing nursing quality through precise risk assessment and individualized interventions, thereby providing new insights for clinical practice. The findings demonstrate that predictive nursing holds significant application value in ECMO anticoagulation management and can serve as an effective approach to improving patient outcomes.
Keywords: Extracorporeal Membrane Oxygenation; Predictive Nursing; Anticoagulation Management; Complication Incidence; Patient Prognosis
目录
摘要 I
Abstract II
引言 1
1 ECMO抗凝管理概述 1
1.2 抗凝管理的核心要素 1
1.3 并发症的常见类型 2
2 并发症预见性护理框架构建 2
2.1 预见性护理的基本原则 2
2.2 并发症风险评估方法 3
2.3 护理干预策略设计 3
3 抗凝管理中的具体护理措施 3
3.1 血栓预防的护理实践 3
3.2 出血控制的护理方案 4
3.3 监测指标的优化管理 4
4 预见性护理的效果评价与改进 5
4.1 护理效果的量化评估 5
4.2 患者预后的数据分析 5
4.3 护理流程的持续优化 6
结论 6
参考文献 7
致谢 8
