1例小儿肝移植术后并发小肝综合征的护理体会  

Nursing care for a pediatric patient with small-for-size syndrome after liver transplantation

作　　者：陈锐 赵瑞玲 杨静[1] 马晶[1] CHEN Rui;ZHAO Ruiling;YANG Jing;MA Jing(Second Department of Critical Care Medicine,The First Affiliated Hospital of Xinjiang Medical University,Urumqi,Xinjiang,830054)

机构地区：[1]新疆医科大学第一附属医院重症医学二科,新疆乌鲁木齐830054

出　　处：《中西医结合护理》2025年第4期128-133,共6页Chinese Journal of Integrative Nursing

摘　　要：本文总结1例小儿肝移植术后并发小肝综合征的护理经验。护理团队针对小肝综合征实施人工肝支持治疗并动态监测胆红素水平;通过调整肝素泵速、精准输注血小板及冷沉淀补充纤维蛋白原,有效平衡抗凝与出血风险;采用渐进式喂养方案并更换短肽型营养剂,缓解患儿腹胀,提供营养支持;实施腹水限容性引流联合白蛋白输注及利尿剂治疗,控制腹围增长并避免电解质紊乱;强化环境消毒、动态监测降钙素原并规范抗感染治疗,积极控制感染。同时,全程强化心理护理,提高患儿依从性。经综合干预,患儿病情趋于稳定,最终顺利出院。This article outlines the nursing process for a 12-year-old pediatric patient who developed small-for-size syndrome after liver transplantation.Key nursing issues included:Applying artificial liver support systems and continuously monitoring of bilirubin levels;Effectively balancing the risks of anticoagulation and bleeding by adjusting heparin infusions,precise platelet infusions and providing fibrinogen supplementation;adopting progressive feeding and peptidebased enteral nutrition plan,and reliving the abdominal distension;strict volume control in the drainage of ascites,albumin and diuretic therapy,management of increase in abdominal circumference and prevention of electrolyte disorders;enhancing environmental disinfection,dynamically monitoring of procalcitonin and standardized anti-infection treatment.Additionally,psychological care was provided to increase the pediatric patient’s compliance with treatment.

关 键 词：儿童 肝移植 小肝综合征 感染 营养支持 腹水 心理护理 

分 类 号：R473.5[医药卫生—护理学]