胆道闭锁患儿肝移植术后并发症的观察及护理  

Nursing of Complications after Liver Transplantation in Children with Biliary Atresia

作　　者：田文杰 吕毅[1,2] 王凯玲 杨勤玲[1] 肖奇贵 TIAN Wen-jie;LV Yi;WANG Kai-ling;YANG Qin-ling;XIAO Qi-gui(Dept.of Hepatobiliary Surgery,the First Affiliated Hospital of Xi’an Jiaotong University,Xi’an 710061,China;National Local Joint Engineering Research Center for Precision Surgery&Regenerative Medicine,the First Affiliated Hospital of Xi’an Jiaotong University,Xi’an 710061,China)

机构地区：[1]西安交通大学第一附属医院肝胆外科,陕西西安710061 [2]西安交通大学第一附属医院精准外科与再生医学国家地方联合工程研究中心,陕西西安710061

出　　处：《护理学报》2021年第18期50-52,共3页Journal of Nursing（China）

基　　金：国家自然科学基金项目(81727802,81470896)。

摘　　要：目的总结胆道闭锁患儿肝移植术后并发症的观察及护理要点,并推广护理经验。方法对4例胆道闭锁患儿行肝脏原位植入术术后血管并发症、感染的预防及控制、消化道瘘及术后营养支持、胆道并发症等的观察和针对性护理措施进行分析,总结护理经验。结果1例患儿术后出现感染症状,给予动态调整抗感染方案,落实保护性隔离措施,顺利出院。1例患儿术后出现了消化道瘘,经过手术及营养支持,严密观察治疗后消化道功能逐渐恢复,经过积极治疗护理,顺利康复出院。4例患者出院后随防至术后1年,无其他严重并发症。结论胆道闭锁患儿肝移植术后在做好常规围手术期管理的基础上,重视患儿术后血管并发症、感染、消化道瘘等并发症的观察护理,同时根据患儿术中情况,个体差异等特例,预警可能出现并发症,改善肝移植患儿预后,促进患儿康复。Objective To summarize the observation and nursing points of postoperative complications in children with biliary atresia after liver transplantation,and to popularize the nursing experience.Methods Four children with biliary atresia received liver transplantation.Postoperative complications including vascular complications,biliary complications,prevention and control of infection,and gastrointestinal fistula and biliary complications were observed.Targeted nursing measures such as postoperative nutritional support were provided,then the nursing experience was summarized.Results One child with infection after operation was given dynamic anti-infection program and protective isolation measures then discharged successfully.One child had gastrointestinal fistula after surgery.With operation treatment and nutritional support,the digestive tract function gradually recovered and the child discharged after close observation and treatment.one-year follow-up found no other serious complications in 4 patients after discharge.Conclusion Close observation and nursing of complications in children after liver transplantation can significantly improve the prognosis of children with liver transplantation,improve the survival rate,and the rehabilitation of liver transplantation in children.

关 键 词：胆道闭锁 小儿肝移植 并发症 护理 

分 类 号：R473.6[医药卫生—护理学]