循环功能不稳定中国一类捐献供体行体外膜肺氧合支持的护理  

Extracorporeal membrane oxygenation support for brain-dead organ donors with unstable hemodynamic condition:nursing care

作　　者：蓝倩[1] 孙煦勇[1] 秦科[1] 李壮江[1] 董建辉[1] 曹嵩[1] 蓝柳根[1] 李美思[1] 黄晨[1] 周洁惠[1] 胡国庆[1] 詹军[1] 农玉荷 刘露[1] 

机构地区：[1]中国人民解放军第303医院器官移植中心/广州军区肝,肾移植中心/广西移植医学重点实验室,广西南宁530021

出　　处：《护理学杂志》2015年第4期26-29,共4页

基　　金：广西壮族自治区科研基金资助项目(10169-05)

摘　　要：目的探讨体外膜肺氧合用于循环功能不稳定中国一类器官捐献供体的器官保护效果及护理要点。方法对13例血流动力学不稳定的国际标准化脑死亡器官捐献(DBD)供者,经股动静脉插管,实施体外膜肺氧合支持下于手术室获取供肝和供肾;术中做好循环、呼吸支持,及时调整药物用量,预防感染及记录各项数据等护理。结果 13例DBD供者行体外膜肺氧合转流期间,血流动力学逐步稳定,获取有效肾脏26个用于26例受者、有效肝脏12个用于12例受者,肾移植、肝移植手术均顺利完成。结论体外膜肺氧合是捐献供体器官保护的有效治疗手段,有效的护理是体外膜肺氧合成功运行的重要保证。Objective To explore the protective effects of extracorporeal membrane oxygenation（ECMO）support for hemodynamically unstable brain-dead organ donors and to summarize nursing experience.Methods Thirteen brain-dead donors in unstable hemodynamic status received veno-arterial ECMO,then the liver and kidney were harvested.Nursing interventions included cardiopulmonary support,adjustment of drug doses,infection prevention,and data documentation,etc.Results All donors achieved hemodynamic stability.Twenty six kidneys were transplanted to 26 recipients and liver transplantation was performed in 12 recipients.All transplantations were successfully completed.Conclusion ECMO support plays an important role in protecting organs in potential organ donors after bain death.Effective nursing interventions are components of the success.

关 键 词：器官捐献 供体 脑死亡 中国分类标准 血流动力学 体外膜肺氧合 护理 

分 类 号：R473.6[医药卫生—护理学] R167[医药卫生—临床医学]