Chinese Journal of Nursing ›› 2023, Vol. 58 ›› Issue (20): 2459-2463.DOI: 10.3761/j.issn.0254-1769.2023.20.004

• Special Planning—Gastrointestinal Disease Care • Previous Articles     Next Articles

Nursing care of transjugular intrahepatic portosystemic shunt in a child with pyrrolizidine alkaloid associated hepatic sinusoidal obstruction syndrome

JIANG Junmei(), YU Zhuowen(), ZHOU Yiwen, HUANG Yuyan, GOU Zhaoyang, HUANG Weiwei, LU Yi   

  • Received:2023-02-08 Online:2023-10-20 Published:2023-10-19
  • Contact: YU Zhuowen

1例肝窦阻塞综合征患儿行经颈静脉肝内门体分流术的护理

姜军妹(), 余卓文(), 周壹文, 黄雨滟, 缑兆阳, 黄微维, 陆怡   

  1. 201102 上海市 复旦大学附属儿科医院肝病科

Abstract:

This study summarized the experience in caring pediatric pyrrolizidine alkaloid-associated hepatic sinusoidal obstruction syndrome after being treated with a transjugular intrahepatic portosystemic shunt(TIPS). The key points of before-surgery care include timely implementation of anticoagulant therapy and ensuring the safety of medication administration;dynamic monitoring of disease changes and applying scientific management of ascites. The key points of post-surgery care include solidifying sheath care to maintain catheter function;enhancing monitoring of the patient’s condition and medication instruction to prevent hepatic encephalopathy and intra-stent thrombosis;correcting assessment of nutritional status and formulation of nutritional support programs;conducting health education and establishing a multi-platform follow-up model. After 2 months of careful treatment and nursing,the child made a good recovery at the 6-month follow-up.

Key words: Hepatic Sinusoidal Obstruction Syndrome, Pyrrolidine Alkaloid, Portosystemic Shunt, Transjugular Intrahepatic, Pediatric Nursing

摘要:

总结1例吡咯生物碱相关性肝窦阻塞综合征患儿行经颈静脉肝内门体分流术的护理经验。术前护理要点:早期实施抗凝治疗,保障用药安全;动态监测病情变化,科学管理腹水。术后护理要点:夯实鞘管护理,确保分流通畅;加强病情观察及用药指导,预防肝性脑病及支架内血栓形成;及时评估营养状况,制订营养支持方案;开展健康宣教,通过多平台随访。经过2个月的精心治疗与护理,患儿好转出院。门诊随访6个月时,患儿恢复良好。

关键词: 肝窦阻塞综合征, 吡咯生物碱, 门体分流术, 经颈静脉肝内, 儿科护理学