64例改良式同侧胰肾联合移植围术期护理临床效果评价分析  

Perioperative nursing of 64 cases of modified ipsilateral simultaneous pancreas kidney transplantation: a clinical effect evaluation analysis

作　　者：邓绚莹 张伟婷[1] 李嘉莉[1] 金敏[1] 张婉祎 Deng Xuanyin;Zhang Weiting;Li Jiali;Jin Min;Zhang Wanyi(Department of Organ Transplantation,Second Affiliated Hospital of Guangzhou Medical University,Guangzhou 510260,Guangdong,China)

机构地区：[1]广州医科大学附属第二医院器官移植中心,广东广州510260

出　　处：《实用器官移植电子杂志》2020年第3期180-185,共6页Practical Journal of Organ Transplantation(Electronic Version)

摘　　要：目的探讨改良式同侧胰肾联合移植围术期护理的临床效果。方法以广州医科大学附属第二医院器官移植中心2016年9月-2018年12月64例接受改良新术式同侧胰肾联合移植的受者为研究对象,探讨围术期护理要点。结果 64例患者取得较好的临床疗效,术后1、3、6、12、24个月的血肌酐为(119.85±51.39)μmol/L、(114.38±43.78)μmol/L、(115.42±44.62)μmol/L、(110.96±28.94)μmol/L、(112.48±34.57)μmol/L,空腹血糖为(5.63±1.38) mmol/L、(4.80±0.45) mmol/L、(4.95±0.66) mmol/L、(4.80±0.56) mmol/L、(4.82±0.53) mmol/L。人、胰腺、肾脏1年及2年累计存活率分别为94.4%、92.9%、92.9%和94.4%、92.9%、92.9%。术后1例因移植胰腺排斥出现胰十二指肠漏、1例因移植胰血栓形成切除移植胰,其余受者移植胰腺功能均恢复良好,术后2~3 d血糖即可降至正常水平,完全摆脱胰岛素;术后1例出现移植肾功能延迟恢复1例移植肾失功,其余受者移植肾功能均恢复良好。结论 64例胰肾联合移植围术期护理取得较好的临床效果,对临床护理有一定的指导和借鉴意义。Objective To explore the clinical effect of perioperative nursing on modified ipsilateral simultaneous pancreas and kidney transplantation. Methods From September 2016 to December 2018, 64 patients who underwent ipsilateral simultaneous pancreas and kidney transplantation with modified operation in the Organ Transplantation Center of the Second Affiliated Hospital of Guangzhou Medical University were analyzed. The main points of perioperative nursing were discussed. Results 64 patients achieved good clinical results. The serum creatinine levels at 1, 3, 6, 12 and 24 months after operation were(119.85±51.39) μmol/L,(114.38± 43.78) μmol/L,(115.42±44.62) μmol/L,(110.96±28.94) μmol/L,(112.48±34.57) μmol/L, fasting blood glucose were(5.63±1.38) mmol/L,(4.80±0.45 mmol/L,(4.95±0.66) mmol/L,(4.80±0.56) mmol/L,( 4.82±0.53) mmol/L. The cumulative survival rates of recipient, pancreas and kidney in one year and two years were 94.4%, 92.9%, 92.9% and 94.4%, 92.9% and 92.9%, respectively. One patients underwent pancreatectomy due to pancreaticoduodenal leakage caused by pancreatic rejection and sepsis;one patient due to pancreatic thrombosis after transplantation. The other patients recovered well in terms of pancreatic function, and blood sugar could be reduced to normal level at 2 to 3 days after operation, insulin could be completely withdrawn after operation. One case had delayed recovery of renal allograft function, one case had renal allograft failure,the rest of the recipients recovered well. Conclusion The nursing experience on 64 cases of simultaneous pancreas and kidney transplantation summarized in our center has certain significance of guidance and reference for clinical nursing.

关 键 词：胰肾联合移植 围术期 护理 

分 类 号：R473.6[医药卫生—护理学]