肝移植病人手术前后血气分析及护理对策  

Blood gas analysis of patients before and after liver transplantation and nursing strategies for them

作　　者：唐晟[1] 皮红英[1] 马燕兰[1] 李冰[1] 王彬[1] 邹国芬[1] 

机构地区：[1]中国人民解放军总医院

出　　处：《护理研究（中旬版）》2009年第10期2645-2647,共3页Chinese Nursing Researsh

摘　　要：[目的]了解肝移植病人术前和术后24h内血气分析变化规律,总结肝移植术后呼吸功能和酸碱平衡的监测及护理措施,为规范肝移植术后护理程序提供依据。[方法]采用GEM3000床旁血气分析仪为57例肝移植病人在术前、术后返回重症监护病房(ICU)后即刻及术后24h行血气分析检查。[结果]肝移植病人酸碱度(pH)、剩余碱(BE)和碳酸氢盐(HCO3-)变化趋势相同,术后返ICU即刻较术前降低,术后24h高于术前水平;氧分压(PaO2)在返ICU即刻异常增高(P<0.01),术后24h有所降低,但仍高于术前(P<0.01);术后二氧化碳分压(PaCO2)与术前比较差异无统计学意义,术后24hPaCO2较返ICU即刻升高明显(P<0.01)。[结论]肝移植病人术后24h内呼吸功能较差,发生代谢性酸中毒的危险性高,术后早期应采取有效的呼吸和酸碱平衡监护措施。Objective：To know the 24 - hour change regularity of blood gas analysis of patients before and after undergoing liver transplantation,it summarized the monitoring of respiratory function and acid--base balance of patients after liver transplantation and nursing strategies for them, so as to provide some bases for standardizing of nursing procedures of patients after accepting liver transplantation. Methods：Blood gas analysis of a total of 57 patients accepting liver transplantation were carried out before operation, right after returning to ICU after operation,and 24 hours after operation respectively by using GEM3000 bedside blood gas analyzer. Results： Blood pH, PaO2 and HCO3^- of patients had the same change trend. Blood pH, PaO2 and HCO3^- levels of patients right after returning to ICU were lower than that of before operation. And blood pH,PaO2 and HCO3^- levels of them at 24 hours after operation were higher than that of before operation. Blood PaO2 level of patients was abnormally high right after returning to ICU （P〈0.01） ,and was lower at 24 hours after operation. However, it was still higher than that of before operation （P〈0.01）. In terms of PaCO2 level,there was no significant difference between before and after operation. Blood PaCO2 of patients at 24 hours after operation was significantly higher than that of before operation （P〈0.01）. Conclusion：Patients＇ respiratory function after 24 hours of liver transplantation was poor. The risk of patients complicating metabolic acidosis was high. Therefore, effective monitoring measures of respiratory and acid - base balance should be taken for them early after operation.

关 键 词：肝移植 血气分析 酸碱平衡 呼吸功能 护理 

分 类 号：R473.6[医药卫生—护理学]