1例肝移植术后门静脉血栓形成继发肝衰竭患者的护理

doi:10.3761/j.issn.0254-1769.2020.12.017

中华护理杂志 ›› 2020, Vol. 55 ›› Issue (12): 1855-1858.DOI: 10.3761/j.issn.0254-1769.2020.12.017

1例肝移植术后门静脉血栓形成继发肝衰竭患者的护理

沈鸣雁(),鲁剑芳,金亚仙,张园园,陈翔,冯志仙()

310021 杭州市浙江树人大学树兰国际医学院附属树兰（杭州）医院护理部（沈鸣雁,陈翔,冯志仙）,肝移植病房（鲁剑芳）,手术室（金亚仙）,重症监护室（张园园）

收稿日期:2020-05-18 出版日期:2020-12-15 发布日期:2020-12-08
通讯作者: 冯志仙
作者简介:沈鸣雁：女,本科（硕士在读）,副主任护师,E-mail：mingyan.shen@shulan.com
基金资助:
浙江省医药卫生科技计划项目(2019KY143)

Nursing care of a patient with portal vein thrombosis secondary liver failure after liver transplantation

SHEN Mingyan(),LU Jianfang,JIN Yaxian,ZHANG Yuanyuan,CHEN Xiang,FENG Zhixian()

Received:2020-05-18 Online:2020-12-15 Published:2020-12-08
Contact: Zhixian FENG

摘要/Abstract

摘要：

总结1例肝移植术后门静脉血栓形成继发移植肝衰竭患者行再次肝移植的护理过程。护理要点：依托多学科合作,人工肝支持治疗过程中确保抗凝药物剂量精准、密切观察凝血指标、落实出血防范措施;再次肝移植围手术期做好血栓预防措施、动态监测肝脏血流变化;实施最小免疫抑制治疗期间,严密防范急性排斥反应和感染;并发乳糜瘘期间做好低脂饮食和引流管护理。患者于入院后第63天步行出院。

关键词: 肝移植, 门静脉, 血栓栓塞, 肝功能衰竭, 护理

Abstract:

To summarize the nursing process of a patient with portal vein thrombosis secondary liver failure after liver transplantation who underwent a liver re-transplantation. Nursing points：Based on collaboration of multi-disciplinary teams,during the process of artificial liver support treatment,the accuracy of the dosage of anticoagulant drugs was ensured;coagulation indicators were observed closely,and bleeding prevention measures were implemented. The measures to prevent thrombosis during the perioperative period of re-transplantation were taken and liver blood flow changes were dynamically monitored. During the implementation of minimal immunosuppressive therapy,acute rejection and infection were strictly prevented;during the concurrent chylofistula,a low-fat diet and drainage tube care were carried out. The patient was discharged on foot on the 63rd day after admission.

Key words: Liver Transplantation, Portal Vein, Thromboembolism, Liver Failure, Nursing Care

沈鸣雁,鲁剑芳,金亚仙,张园园,陈翔,冯志仙. 1例肝移植术后门静脉血栓形成继发肝衰竭患者的护理[J]. 中华护理杂志, 2020, 55(12): 1855-1858.

SHEN Mingyan,LU Jianfang,JIN Yaxian,ZHANG Yuanyuan,CHEN Xiang,FENG Zhixian. Nursing care of a patient with portal vein thrombosis secondary liver failure after liver transplantation[J]. Chinese Journal of Nursing, 2020, 55(12): 1855-1858.

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1例肝移植术后门静脉血栓形成继发肝衰竭患者的护理

Nursing care of a patient with portal vein thrombosis secondary liver failure after liver transplantation

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