1例双肺移植术后患者并发特发性高氨血症的护理

doi:10.3761/j.issn.0254-1769.2022.21.012

中华护理杂志 ›› 2022, Vol. 57 ›› Issue (21): 2635-2638.DOI: 10.3761/j.issn.0254-1769.2022.21.012

1例双肺移植术后患者并发特发性高氨血症的护理

曾妃(), 梁江淑渊, 兰美娟(), 林闰麒

310000 杭州市浙江大学医学院附属第二医院护理部

收稿日期:2021-11-22 出版日期:2022-11-10 发布日期:2022-10-27
通讯作者: 兰美娟，E-mail：lanmj@zju.edu.cn
作者简介:曾妃：女，本科（硕士在读），副主任护师，科护士长，E-mail：zengfei@zju.edu.cn
基金资助:
浙江省医药卫生科技计划项目(2021KY713);浙江省医药卫生科技计划项目(2021KY169)

Nursing care of a patient complicated with idiopathic hyperammonemia after double lung transplantation

ZENG Fei(), LIANG Jiangshuyuan, LAN Meijuan(), LIN Runqi

Received:2021-11-22 Online:2022-11-10 Published:2022-10-27

摘要/Abstract

摘要：

总结1例双肺移植术后并发特发性高氨血症患者的护理经验。护理要点：肺移植术后特发性高氨血症的早期预警;综合性降氨治疗的护理，包括间歇性血液透析联合连续性肾脏替代治疗的护理、药物降氨护理、动态化的营养支持护理;加强免疫抑制药物的特殊管理;实施移植肺功能的持续性个性化训练;开展认知功能训练。经过积极治疗，患者意识转清，血氨浓度恢复正常，顺利出院。

关键词: 肺移植, 特发性高氨血症, 肾替代疗法, 护理

Abstract:

To summarize the nursing experience of a patient complicated with idiopathic hyperammonemia after double lung transplantation. Nursing points include the early warning of idiopathic hyperammonemia after lung transplantation;care of comprehensive ammonia lowering therapy，including intermittent hemodialysis and continuous kidney replacement therapy，drug ammonia lowering therapy，dynamic nutrition support care;special management of immunosuppressive drugs;continuous individualized training of transplanted lung function;care of cognitive impairment caused by cerebral cortex damage. After the active treatment，the patient was transferred，and the blood ammonia concentration returned to normal. The patient was discharged smoothly.

Key words: Lung Transplantation, Idiopathic Hyperammonemia, Renal Replacement Therapy, Nursing Care

曾妃, 梁江淑渊, 兰美娟, 林闰麒. 1例双肺移植术后患者并发特发性高氨血症的护理[J]. 中华护理杂志, 2022, 57(21): 2635-2638.

ZENG Fei, LIANG Jiangshuyuan, LAN Meijuan, LIN Runqi. Nursing care of a patient complicated with idiopathic hyperammonemia after double lung transplantation[J]. Chinese Journal of Nursing, 2022, 57(21): 2635-2638.

参考文献 13

[1]	Leger RF, Silverman MS, Hauck ES, et al. Hyperammonemia post lung transplantation:a review[J]. Clin Med Insights Circ Respir Pulm Med, 2020, 14:1179548420966234.
[2]	Matson KM, Sonetti DA. Successful treatment of ureaplasma-induced hyperammonemia syndrome post-lung transplant[J]. Tra-nspl Infect Dis, 2019, 21:e13022.
[3]	Chen C, Bain KB, Iuppa JA, et al. Hyperammonemia syndrome after lung transplantation:a single center experience[J]. Transplantation, 2016, 100(3):678-684. DOI URL
[4]	Wang X, Greenwood-Quaintance KE, Karau MJ, et al. Ureaplasma parvum causes hyperammonemia in a pharmacologically im-munocompromised murine model[J]. Eur J Clin Microbiol Infect Dis, 2017, 36(3):517-522. DOI URL
[5]	Higgins AB, Farmakiotis D, Rogers R, et al. Hyperammonemia syndrome due to ureaplasma urealyticum in a kidney transplant recipient:a case of disseminated disease from a fluoro-quinolone-resistant isolate[J]. Transpl Infect Dis, 2020, 22(5):e13328.
[6]	Tantengco OAG, De Jesus FCC Ⅱ, Gampoy EFS, et al. Hyperammonemia syndrome associated with ureaplasma spp. infections in immunocompromised patients and transplant recipi-ents:a systematic review and meta-analysis[J]. Clin Transplant, 2021, 35(7):e14334.
[7]	Krutsinger D, Pezzulo A, Blevins AE, et al. Idiopathic hyperammonemia after solid organ transplantation:primarily a lung problem? A single-center experience and systematic review[J]. Clin Transplant, 2017, 31(5):e12957. DOI URL
[8]	Seo Y, Lee HJ, Ha EJ, et al. 2021 KSCCM clinical practice guidelines for pain,agitation,delirium,immobility,and sleep dis-tur-bance in the intensive care unit[J]. Acute Crit Care, 2022, 37(1):1-25. DOI URL
[9]	Chan PG, Kusztos A, Thorngren C, et al. Emergent plasmapheresis for hyperammonemia in a re-do double lung transplant patient[J]. Ann Thorac Surg, 2021, 112(1):e45-e47. DOI PMID
[10]	Andrew ZF, John CS, Lesley R, et al. Intermittent dialysis and continuous modalities for patients with hyperammonemia[EB/OL]. (2021-10-27)[2022-04-23]. https://www.uptodate.cn/contents/intermittent-dialysis-and-continuous-modalities-for-patients-with-hyperammonemia.
[11]	中国妇幼保健协会儿童疾病和保健分会遗传代谢学组. 鸟氨酸氨甲酰转移酶缺乏症诊治专家共识[J]. 浙江大学学报(医学版), 2020, 49(5):539-547.
	Division of Genetics and Metabolism,Child Diseases and Health Care Branch, Chinese Association for Maternal and Child Health. onsensus on diagnosis and treatment of orni-thine transcarbamylase deficiency[J]. J Zhejiang Univ (Med Sci), 2020, 49(5):539-547.
[12]	中华医学会器官移植学分会. 中国肺移植免疫抑制治疗及排斥反应诊疗规范(2019版)[J]. 中华移植杂志(电子版), 2019, 13(2):94-98.
	Chinese Society of Organ Transplantation. Diagnosis and treatment specification for immunosuppressive therapy and rejection of lung transplantation in China(2019 edition)[J]. Chin J Transplant(Electron Version), 2019, 13(2):94-98.
[13]	兰美娟, 曾妃, 梁江淑渊. 双肺移植患者肺康复方案的构建与应用[J]. 中华护理杂志, 2022, 57(6):659-665. DOI
	Lan MJ, Zeng F, Liang JSY. Construction and application of a pulmonary rehabilitation program in patients with double lung transplantation[J]. Chin J Nurs, 2022, 57(6):659-665. DOI

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1例双肺移植术后患者并发特发性高氨血症的护理

Nursing care of a patient complicated with idiopathic hyperammonemia after double lung transplantation

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