心腎症候群的體液處置原則概論

Overview of the Fluid Management Strategy in Cardiorenal Syndrome

鍾雨珍(Yu-Chen Chung) ； 陳俞琪(Yu-Chi Chen)

《榮總護理》 37卷2期 (2020/06) Pp. 184-191

https://doi.org/10.6142/VGHN.202006_37(2).0009

摘要

心腎症候群是指一種心臟和腎臟相互依存的狀態，隨著病程進展，在心腎相互影響之下，出現心臟和腎臟功能的障礙，體內產生水分滯留。體液過多是患者反覆入院最常見原因，此問題不僅影響病人生活品質，更會延長住院日數，及增加死亡率。因此，擬定液體管理策略是照護此類病人重要照護議題。在讓體液達到平衡時，也需要防範脫水不當或循環血量減少引起的灌注不足，而造成遠端器官受損。根據臨床指標及系統性身體評估、設定合適的液體目標值，透過適當的臨床處置與照護介入，以維持適當體液容積，乃是照護心腎症候群病人的首要任務。由於目前國內針對心腎症候群液體管理相關論述與研究甚少，本文期望進一步統整心腎症候群體液調控機制的實證結果，提出有效的液體管理策略，作為實務照護應用時之參考。

關鍵字

心腎症候群 ； 液體管理

並列摘要

Cardiorenal syndrome (CRS) refers to the state of interdependence between the heart and kidneys. When the functions of these organs are impaired through disease, fluids accumulate in the body due to the organs' mutual influence. Thus, excess water retention is the most common reason for rehospitalization among patients with CRS. This issue not only affects patients' quality of life but also increases their hospital stay and mortality rate. Therefore, the development of fluid management strategies is crucial for patients with CRS. When providing nursing interventions to promote fluid balance, improper dehydration and loss of circulating blood volume must be prevented because they can induce distant organ impairment through organ hypoperfusion. Therefore, maintaining a balanced fluid volume through proper clinical management is a priority for care in patients with CRS. This care should be based on objective clinical indicators, systematic physical examination, and the determination of a suitable fluid volume level. However, because few studies have investigated fluid management among patients with CRS, this review aimed to explain the mechanism of fluid regulation and integrate empirical assessment and management results by summarizing relevant studies and developing a fluid management strategy that can serve as a reference for nursing practice.

並列關鍵字

cardiorenal syndrome ； fluid management

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