中华护理杂志 ›› 2021, Vol. 56 ›› Issue (7): 1062-1065.DOI: 10.3761/j.issn.0254-1769.2021.07.018

• 临床实践 • 上一篇    下一篇

1例血型不合非活体肝移植患儿术后急性抗体介导排斥反应的护理

梁江淑渊(),曾妃()   

  1. 310000 杭州市 浙江大学医学院附属第二医院综合ICU
  • 收稿日期:2020-11-16 出版日期:2021-07-15 发布日期:2021-06-29
  • 通讯作者:
  • 作者简介:梁江淑渊:女,硕士,护师,E-mail: 2517140@zju.edu.cn
  • 基金资助:
    浙江省医药卫生科技计划项目(2020376313);浙江省教育厅项目(Y201941199)

Nursing of acute antibody-mediated rejection in a child with blood incompatibility non-living donor liver transplantation

LIANG Jiangshuyuan(),ZENG Fei()   

  • Received:2020-11-16 Online:2021-07-15 Published:2021-06-29

摘要:

总结1例ABO血型不合非活体肝移植患儿术后急性抗体介导排斥反应的护理经验。护理要点包括:严密监测病情变化,及时启动应急预案,全程监测移植肝功能;免疫抑制药物精准化管理;血浆置换期间做好各项监测,包括不良反应、滤器抗凝和凝血功能的监测,进行滴定式浅镇静管理和管路安全管理;消化道出血期间,提供合理的营养支持;严格执行医院感染防控措施。经过积极治疗,患儿安全度过急性排斥反应,最终康复出院。

关键词: 肝移植, 血型不合, 急性抗体介导排斥反应, 儿科护理学

Abstract:

To summarize the nursing care of acute antibody-mediated rejection in a child with blood incompatibility after non-living donor liver transplantation. Nursing points:strictly monitor changes in the condition,promptly initiate response plans,and monitor liver function throughout the whole process;perform various monitoring during plasma exchange,including monitoring of adverse reactions,filter anticoagulation and coagulation functions,titration sedation management and pipeline safety management;precise immunosuppressive drug treatment;provide reasonable nutritional support during gastrointestinal bleeding;strictly implement nosocomial infection prevention and control measures. After active treatment,the child survived the acute rejection safely and eventually recovered and was discharged.

Key words: Liver Transplantation, Blood Incompatibility, Acute Antibody-Mediated Rejection, Pediatric Nursing