K胺中毒致急性肝衰竭行肝移植术患者的护理1例  

Nursing care of a patient with acute liver failure caused by K-amine poisoning undergoing liver transplantation

作　　者：章琳[1] 卢芳燕 卢露 吕璐洋 Zhang Lin;Lu Fangyan;Lu Lu;Lyu Luyang(Liver Transplantation Unit,the First Affiliated Hospital of Zhejiang University Medical College,Hangzhou 310003,China)

机构地区：[1]浙江大学医学院附属第一医院肝移植病房,杭州310003

出　　处：《中国实用护理杂志》2023年第27期2146-2150,共5页Chinese Journal of Practical Nursing

基　　金：浙江省医药卫生科技计划项目(2020KYS37)。

摘　　要：目的总结1例因K胺中毒致急性肝衰竭、肾损伤、休克、肝性脑病、高乳酸血症的患者行肝移植术的护理经验,为临床提供参考。方法对浙江大学医学院附属第一医院2022年6月29日收治的1例K胺中毒重症患者开展多学科团队协作诊疗,采用血液净化联合肝移植术的治疗方案,在液体复苏、血液净化、肝性脑病脑水肿和感染等并发症防治、肝移植术后免疫抑制治疗、职业防护、健康教育和随访管理等方面实施个体化的护理措施。结果经过精心的治疗和护理,患者肝肾功能恢复顺利,肝移植术后第33天出院。结论针对K胺中毒致急性肝衰竭病情进展快、多器官累及的问题,在多学科团队协作下,通过血液净化联合肝移植术成功挽救了患者的生命,临床医护人员需要做好病情监测和个体化的护理,提高患者长期存活率。Objective To summarize the nursing experience of liver transplantation in a patient with acute liver failure,renal injury,shock,hepatic encephalopathy and hyperlactic acidemia caused by K-amine poisoning.Methods A case of severe K-amine poisoning admitted to the First Affiliated Hospital of Zhejiang University Medical College on June 29,2022 was treated by multidisciplinary team cooperation.The treatment scheme of blood purification combined with liver transplantation was adopted,individualized nursing measures were implemented,including fluid resuscitation,blood purification,prevention and treatment of complications such as brain edema and infection of hepatic encephalopathy,immunosuppressive treatment after liver transplantation,occupational protection,health education and follow-up management.Results After careful treatment and nursing,the liver and kidney function of the patient recovered smoothly and was discharged on the 33rd day after liver transplantation.Conclusions In view of the rapid progress of acute liver failure caused by K-amine poisoning and the involvement of multiple organs,blood purification combined with liver transplantation successfully saved the lives of patients under the cooperation of multidisciplinary teams.Do a good job in disease monitoring and individualized nursing to improve the long-term survival rate of patients.

关 键 词：肝功能衰竭 急性 肝移植 护理 2-氨基-5-氯-N 3-二甲基苯甲酰胺 

分 类 号：R473.6[医药卫生—护理学]