1例肾移植术后移植物功能延迟恢复合并消化道大出血患儿的护理

doi:10.3761/j.issn.0254-1769.2025.22.013

中华护理杂志 ›› 2025, Vol. 60 ›› Issue (22): 2766-2770.DOI: 10.3761/j.issn.0254-1769.2025.22.013

1例肾移植术后移植物功能延迟恢复合并消化道大出血患儿的护理

沈丹军(), 诸纪华, 傅藏藏, 冯佳艳, 盛美君()

310052 杭州市浙江大学医学院附属儿童医院外科重症监护室（沈丹军，盛美君），护理部（诸纪华，傅藏藏），国际医学部（冯佳艳）

收稿日期:2024-12-12 出版日期:2025-11-20 发布日期:2025-11-13
通讯作者: 盛美君，E-mail：smj512@zju.edu.cn
作者简介:沈丹军：男，本科（硕士在读），护师，E-mail：6518111@zju.edu.cn

Nursing care of a child with delayed graft function and massive gastrointestinal hemorrhage after renal transplantation

SHEN Danjun(), ZHU Jihua, FU Cangcang, FENG Jiayan, SHENG Meijun()

Received:2024-12-12 Online:2025-11-20 Published:2025-11-13

摘要/Abstract

摘要：

总结1例肾移植术后移植物功能延迟恢复合并消化道大出血患儿的护理体会。护理要点：维持移植肾血液灌注，改善移植物功能延迟恢复症状；执行科学的免疫抑制管理策略，提供精准化用药护理；启动高效抗休克治疗，积极配合内镜下止血；落实胃肠道保护措施，实现消化道出血与免疫抑制协同护理；实施分阶段的营养支持方案，维持胃肠道稳态；开展个体化康复护理，缓解患儿及其家长的负性情绪。经过精心的治疗与护理，患儿术后59 d顺利出院，随访1年，移植肾功能恢复良好，回归正常生活。

关键词: 肾移植, 移植物功能延迟恢复, 消化道出血, 儿科护理学

Abstract:

To summarize the nursing care of a child with delayed graft function and massive gastrointestinal hemorrhage after renal transplantation. Nursing focuses are as following：to maintain blood perfusion of transplanted kidney，to improve delayed recovery of graft function；to implement scientific immunosuppressive management strategies，to provide accurate medication care；to start highly effective anti-shock treatment，to actively cooperate with endoscopic hemostasis；to implement gastrointestinal protection measures，to achieve gastrointestinal bleeding and immunosuppression coordinated care；implementation of phased nutritional support program to maintain gastroin-testinal homeostasis；to carry out individual rehabilitation nursing，to alleviate the negative emotions of children and their families. After careful treatment and nursing care，the children were discharged 59 days after operation and followed up for 1 year，and the transplanted kidney recovered well and the child returned to normal life.

Key words: Kidney Transplantation, Delayed Graft Function, Gastrointestinal Bleeding, Pediatric Nursing

沈丹军, 诸纪华, 傅藏藏, 冯佳艳, 盛美君. 1例肾移植术后移植物功能延迟恢复合并消化道大出血患儿的护理[J]. 中华护理杂志, 2025, 60(22): 2766-2770.

SHEN Danjun, ZHU Jihua, FU Cangcang, FENG Jiayan, SHENG Meijun. Nursing care of a child with delayed graft function and massive gastrointestinal hemorrhage after renal transplantation[J]. Chinese Journal of Nursing, 2025, 60(22): 2766-2770.

参考文献 12

[1]	Lemoine CP, Pozo ME, Superina RA. Overview of pediatric kid-ney transplantation[J]. Semin Pediatr Surg, 2022, 31(3):151194. DOI URL
[2]	Shen Q, Fang XY, Man XY, et al. Pediatric kidney transplan-tation in China:an analysis from the IPNA global kidney repla-cement therapy registry[J]. Pediatr Nephrol, 2021, 36(3):685-692. DOI
[3]	项和立, 王玮, 王建宁, 等. 中国肾脏移植受者移植物功能延迟恢复临床诊疗指南[J]. 器官移植, 2024, 15(5):684-699.
	Xiang HL, Wang W, Wang JN, et al. Guidelines for clinical diagnosis and treatment of delayed graft function in kidney transplant recipients in China[J]. Organ Transplant, 2024, 15(5):684-699.
[4]	丁汉东, 王琴, 廖贵益, 等. 肾移植术后并发消化道出血的诊治[J]. 北京大学学报(医学版), 2024, 56(5):902-907. DOI
	Ding HD, Wang Q, Liao GY, et al. Diagnosis and treatment of gastrointestinal bleeding after kidney transplantation[J]. J Pek-ing Univ Health Sci, 2024, 56(5):902-907.
[5]	Wazir S, Abbas M, Ratanasrimetha P, et al. Preoperative blood pressure and risk of delayed graft function in deceased donor kidney transplantation[J]. Clin Transplant, 2022, 36(9):e14776. DOI URL
[6]	朱有华, 赵闻雨. 儿童肾移植技术操作规范(2019版)[J]. 器官移植, 2019, 10(5):499-504.
	Zhu YH, Zhao WY. Technical operation specification for renal transplantation in children(2019 edition)[J]. Organ Transplant, 2019, 10(5):499-504.
[7]	中华医学会器官移植学分会,中国医疗保健国际交流促进会肾脏移植学分会. 中国肾脏移植受者免疫抑制治疗指南(2023版)[J]. 中华器官移植杂志, 2024, 45(10):645-663.
	Branch of Organ Transplantation,Kidney Transplantation Branch of China International Exchange and Promotion Association for Medical and Health Care. Chinese clinical practice gui-delines for immunosuppressive therapy in kidney transplant recipients(2023 edition)[J]. Chin J Organ Transplant, 2024, 45(10):645-663.
[8]	Henry Z, Patel K, Patton H, et al. AGA clinical practice update on management of bleeding gastric varices:expert review[J]. Clin Gastroenterol Hepatol, 2021, 19(6):1098-1107. DOI URL
[9]	中华医学会内分泌学分会,中国内分泌代谢病专科联盟. 糖皮质激素类药物临床应用指导原则(2023版)[J]. 中华内分泌代谢杂志, 2023, 39(4):289-296.
	Chinese Society of Endocrinology,China Endocrinology and Metabolism Specialist Alliance. Principles for clinical applica-tion of glucocorticoids(2023 edition)[J]. Chin J Endocrinol Metab, 2023, 39(4):289-296.
[10]	马铮铮, 钮美娥, 钱春娅, 等. 1例肾移植术后合并急性抗体介导排斥反应患者的护理[J]. 中华护理杂志, 2023, 58(10):1225-1229. DOI
	Ma ZZ, Niu ME, Qian CY, et al. Nursing of a patient com-bined with acute antibody-mediated rejection after kidney transplantation[J]. Chin J Nurs, 2023, 58(10):1225-1229.
[11]	张荣梅, 杨蓓. 肾移植术后患者焦虑、抑郁及疲乏对其健康影响的纵向研究[J]. 中华护理杂志, 2019, 54(12):1771-1776. DOI
	Zhang RM, Yang B. A longitudinal study of anxiety,depres-sion,fatigue,and their impact on health status in renal tran-splant recipients[J]. Chin J Nurs, 2019, 54(12):1771-1776.
[12]	凌云, 梅伶俐, 诸纪华, 等. 智能化随访系统的研发及在短肠综合征患儿中的应用[J]. 中华急危重症护理杂志, 2023, 4(10):887-892.
	Ling Y, Mei LL, Zhu JH, et al. Development of an intelligent follow-up system and management practice in children with short bowel syndrome[J]. Chin J Emerg Crit Care Nurs, 2023, 4(10):887-892.

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1例肾移植术后移植物功能延迟恢复合并消化道大出血患儿的护理

Nursing care of a child with delayed graft function and massive gastrointestinal hemorrhage after renal transplantation

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