胆管癌患者行离体肝切除联合自体肝移植的围手术期护理  

Perioperative nursing of a patient with cholangiocarcinoma undergoing ex vivo liver resection combined with autologous liver transplantation

作　　者：徐珏华[1] 刘帅 严盛 张启逸 XU Juehua;LIU Shuqi;YAN Sheng;ZHANG Qiyi

机构地区：[1]浙江大学医学院附属第二医院肝胆胰外科,杭州市310013

出　　处：《中华急危重症护理杂志》2023年第10期926-929,共4页Chinese Journal of Emergency and Critical Care Nursing

基　　金：浙江省医药卫生科技项目(2021KY168)。

摘　　要：总结1例胆管癌患者行离体肝切除联合自体肝移植围手术期的护理体会。护理要点:术后1周目标导向精准静脉抗凝护理;利用劳尔比色卡动态观察引流液,主动预防和识别前哨出血;控制腹内压、做好术后24 h内液体管理,保证肝脏有效灌注,降低肝脏缺血和再灌注损伤;围手术期充分观察和预防小肝综合征发生;关注术后胃肠道功能恢复,实施分阶段营养方案。经过精心护理,患者术后第45天康复出院。To summarize the perioperative nursing experience of one patient with cholangiocarcinoma undergoing ex vivo liver resection combined with autologous liver transplantation.Nursing points:goal-oriented precise venous anticoagulation nursing one week after operation,observing the drainage fluid dynamically by Raul colorimetric card to actively prevent and identify sentinel bleeding,controlling intra-abdominal pressure and doing a good job in fluid management within 24 hours after operation to ensure effective liver perfusion and reduce liver ischemia and reperfusion injury,comprehensively preventing and observing the occurrence of small liver syndrome during perioperative period,paying attention to the recovery of gastrointestinal function after operation and implementing the staged nutrition program.After careful nursing,the patient was discharged 45 days after operation.

关 键 词：胆管肿瘤 肝移植 围手术期护理 危重病护理 

分 类 号：R473.73[医药卫生—护理学]