摘要
目的评价下肢灌注评估量表用于股静脉-动脉体外膜氧合(V-A ECMO)患者的临床疗效。方法回顾性分析本院2015年9月至2022年3月行V-A ECMO治疗的患者41例,根据是否应用下肢灌注评估量表分为对照组(n=20)和量表组(n=21)。对照组采用常规护理方案,量表组应用下肢灌注评估量表评估V-A ECMO患者下肢灌注情况。比较两组患者一般资料和下肢缺血发生率,采用Logistic回归分析下肢缺血的危险因素。结果两组患者在一般资料方面差异均无统计学意义(P>0.05),在下肢缺血发生率方面存在统计学差异(4.8%vs.30.0%,P=0.045)。多因素Logistic回归分析结果显示未使用下肢灌注评估量表(OR=1.12,95%CI:1.06~1.18,P=0.025)、未预置远端灌注管(OR=1.55,95%CI:1.08~2.23,P=0.018)以及未实施清醒ECMO(OR=2.50,95%CI:1.69~3.70,P<0.001)是患者下肢缺血的危险因素。结论应用下肢灌注评估量表能够早期识别V-A ECMO下肢缺血的患者,有利于医护人员尽早实施干预措施,提高护理质量和患者满意度。
Objective To evaluate the clinical efficacy of the perfusion assessment scale in patients with femoral veno-arterial extracorporeal membrane oxygenation(V-A ECMO).Methods The patients underwent V-A ECMO treatment in our hospital from September 2015 to March 2022 were retrospectively analyzed,and they were divided into control group and scale group according to whether the perfusion assessment scale was used or not(n=41).The control group was given routine nursing program(n=20),and the scale group was evaluated using the perfusion assessment scale(n=21).The general data and the incidence of lower extremity is⁃chemia were compared between the two groups,and logistic regression was used to analyze the risk factors of lower extremity ischemia.Results There was no significant difference in general data between the two groups(P>0.05),but there was a statistical difference in the incidence of lower extremity ischemia(4.8%vs.30.0%,P=0.045).In addition,multivariate logistic regression analysis showed that non use of perfusion assessment scale(OR=1.12,95%CI:1.06 to 1.18,P=0.025),non use of distal perfusion catheter(OR=1.55,95%CI:1.08 to 2.23,P=0.018)and unconsciousness ECMO(OR=2.50,95%CI:1.69 to 3.70,P<0.001)were the risk factors for lower extremity ischemia.Conclusion The application of the perfusion assessment scale can identify VA-ECMO pa⁃tients with lower extremity ischemia early,which is helpful for medical staff to implement intervention measures as soon as possible and improve the quality of care and patient satisfaction.
作者
刘艳
陈志兰
曹新颖
孙斌
丁文平
王立伟
甄宁
Liu Yan;Chen Zhilan;Cao Xinying;Sun Bin;Ding Wenping;Wang Liwei;Zhen Ning(Operating Room,Xuzhou Central Hospital,Jiangsu Xuzhou 221000,China)
出处
《中国体外循环杂志》
2023年第2期107-110,128,共5页
Chinese Journal of Extracorporeal Circulation
基金
徐州市卫生健康委青年医学科技创新项目(XWKYHT20210591)。
关键词
静脉-动脉体外膜氧合
下肢
灌注
下肢缺血
评估量表
护理
Veno-arterial extracorporeal membrane oxygenation
Lower limb
Perfusion
Assessment scale
Lower extremity ischemia
Nursing
