肾移植术后包裹性腹膜硬化症的护理  

Nursing experience of encapsulating peritoneal sclerosis following kidney transplantation

作　　者：梁红梅[1] 陈锷[1] 梁小玲[1] 张桓熙[1] 豆秋江[1] LAING Hongmei(Organ transplant center, the first affiliated hospital of Sun Yat-Sen University, Guangzhou, Guangdong,510080, China)

机构地区：[1]中山大学附属第一医院器官移植中心,广东广州510080

出　　处：《齐齐哈尔医学院学报》2019年第8期1043-1045,共3页Journal of Qiqihar Medical University

基　　金：国家自然科学基金(81700655)

摘　　要：国内缺乏肾移植术后包裹性腹膜硬化症(EPS)护理经验的报道,本文报道我中心收治的2个案例。2例患者术前腹膜透析时间分别为17年和11年,均曾发生腹膜炎,肾移植术后出现顽固性消化道症状或腹部症状,经检查诊断为EPS。在护理过程中,护士需充分了解患者术前腹透情况,识别高危因素,警惕EPS发病,术后加强腹膜透析管护理,预防EPS发生,同时密切观察病情变化,协助EPS的及时诊断,EPS治疗时则需积极控制感染,保证充分引流,给予营养支持及做好心理护理。2例患者肾功能均恢复良好,其中1例EPS得到控制,另1例因肠瘘、持续重度营养不良而放弃治疗出院。全面系统的护理服务有利于患者积极配合治疗,提高治疗效果,促进患者身心康复。There were few reports investigating the nursing experience of encapsulating peritoneal sclerosis(EPS) following kidney transplantation.We aimed to report 2 cases in our center.The two patients underwent peritoneal dialysis for 11 and 17 years respectively,and both of them ever suffered with intermittent peritonitis during dialysis.They had refractory intestinal or abdominal symptoms after kidney transplantation and were later diagnosed as EPS.In the process of nursing,nurses were required to fully obtain the information of preoperative peritoneal dialysis,identify high-risk factors,be alert to the onset of EPS,and strengthen peritoneal dialysis tube caring after surgery to prevent EPS.They were also required to closely monitor the changes in the manifestations,assist the doctors in the timely diagnosis of EPS.When treating EPS,nurses should actively control infection,ensure adequate drainage,and provide nutritional support and psychological care.Both two patients had their kidney function recovered after surgery.After the comprehensive treatment to EPS,one patient recovered with good graft function and the other one chose to abandon treatment due to intestinal fistula and persistent severe malnutrition.Comprehensive and systematic nursing services could help improve the patients’ adherence,improve the outcome,and promote physical and mental recovery of patients.

关 键 词：长期腹膜透析 包裹性腹膜硬化症 肾移植术 营养支持 心理护理 

分 类 号：R473[医药卫生—护理学]