1例心肺联合移植术后患者成功妊娠并分娩的护理

doi:10.3761/j.issn.0254-1769.2023.01.011

中华护理杂志 ›› 2023, Vol. 58 ›› Issue (1): 80-84.DOI: 10.3761/j.issn.0254-1769.2023.01.011

1例心肺联合移植术后患者成功妊娠并分娩的护理

李九红(), 董阿兰(), 李亚敏, 刘义婷, 张霞, 谢娟玉, 余梅, 任敏

410000 长沙市中南大学湘雅二医院心血管外科（李九红，董阿兰，张霞，谢娟玉，余梅，任敏），临床护理学教研室（李亚敏，刘义婷）

收稿日期:2022-04-29 出版日期:2023-01-10 发布日期:2022-12-30
通讯作者: 董阿兰，E-mail：dongalan1234@csu.edu.cn
作者简介:李九红：女，硕士，主管护师，E-mail：jiuhongli@csu.edu.cn
基金资助:
湖南省卫生健康委员会一般资助课题(202214023492);中南大学湘雅二医院护理科研基金项目(2019-HLKY-01);中南大学湘雅二医院护理科研基金项目(2020-HLKY-11)

Successful pregnancy and delivery after heart and lung transplantation：a case report

LI Jiuhong(), DONG Alan(), LI Yamin, LIU Yiting, ZHANG Xia, XIE Juanyu, YU Mei, REN Min

Received:2022-04-29 Online:2023-01-10 Published:2022-12-30

摘要/Abstract

摘要：

总结1例心肺联合移植术后患者成功妊娠并分娩的护理经验。护理要点包括：成立围产期母胎心血管疾病多学科团队，提供全程管理；个体化孕前咨询，选择最佳妊娠时机；调整孕期免疫抑制方案，密切监测血药浓度；精细化的妊娠期管理，预防严重并发症的发生；合理选择分娩方式，严密进行产时监护；产后护理及喂养指导；全程心理疏导，增强患者信心。经过精心的治疗及护理，患者成功妊娠并顺利分娩健康婴儿，术后5 d母婴平安出院，产后3个月随访，患者及婴儿状况良好。

关键词: 心肺联合移植, 妊娠, 免疫抑制, 产科护理

Abstract:

To summarize the nursing experience of a patient with successful pregnancy and delivery after heart-lung transplantation. Nursing points include：establishing a multidisciplinary team of perinatal maternal-fetal cardiovascular disease to escort patients for successful delivery； individualized pre-pregnancy counseling to choose the best timing for pregnancy； adjustment of the immunosuppressive regimen during pregnancy and close monitoring of blood drug concentrations； refined pregnancy management，prevention of serious complications； rational selection of the mode of delivery and strict monitoring during labor；postpartum care and feeding guidance； psychological counseling to enhance patient confidence. After careful nursing and guidance，the patient successfully conceived and gave birth to a healthy baby. The mother and baby were discharged safely 5 days after the operation，and they were in good condition after 3 months of follow-up.

Key words: Heart and Lung Transplantation, Pregnancy, Immunosuppression, Obstetrical Nursing

李九红, 董阿兰, 李亚敏, 刘义婷, 张霞, 谢娟玉, 余梅, 任敏. 1例心肺联合移植术后患者成功妊娠并分娩的护理[J]. 中华护理杂志, 2023, 58(1): 80-84.

LI Jiuhong, DONG Alan, LI Yamin, LIU Yiting, ZHANG Xia, XIE Juanyu, YU Mei, REN Min. Successful pregnancy and delivery after heart and lung transplantation：a case report[J]. Chinese Journal of Nursing, 2023, 58(1): 80-84.

参考文献 14

[1]	Murray JE, Reid DE, Harrison JH, et al. Successful pregnancies after human renal transplantation[J]. N Engl J Med, 1963, 269: 341-343. DOI URL
[2]	Löwenstein BR, Vain NW, Perrone SV, et al. Successful pregnancy and vaginal delivery after heart transplantation[J]. Am J Obstet Gynecol, 1988, 158(3 Pt 1):589-590. PMID
[3]	Wagoner LE, Taylor DO, Olsen SL, et al. Immunosuppressive therapy,management,and outcome of heart transplant recipients during pregnancy[J]. J Heart Lung Transplant, 1993, 12(6 Pt 1):993-999.
[4]	Coscia LA, Constantinescu S, Moritz MJ, et al. Report from the National Transplantation Pregnancy Registry(NTPR):outcomes of pregnancy after transplantation[J]. Clin Transpl, 2010:65-85.
[5]	Costanzo MR, Dipchand A, Starling R, et al. The International Society of Heart and Lung Transplantation Guidelines for the care of heart transplant recipients[J]. J Heart Lung Transplant, 2010, 29(8):914-956. DOI URL
[6]	Boyle S, Sung-Him Mew T, Lust K, et al. Pregnancy following heart transplantation:a single centre case series and review of the literature[J]. Heart Lung Circ, 2021, 30(1):144-153. DOI URL
[7]	Macera F, Occhi L, Masciocco G, et al. A new life:motherhood after heart transplantation. A single-center experience and review of literature[J]. Transplantation, 2018, 102(9):1538-1544. DOI URL
[8]	刘佳, 谢建飞, 刘敏, 等. 肾移植患者妊娠及生育健康教育的研究进展[J]. 中华护理杂志, 2018, 53(8):1018-1021.
	Liu J, Xie JF, Liu M, et al. Health education of pregnancy and fertility for kidney transplant recipients:a review[J]. Chin J Nurs, 2018, 53(8):1018-1021.
[9]	Mastrobattista JM, Gomez-Lobo V, Society for Maternal-Fetal Me-dicine. Pregnancy after solid organ transplantation[J]. Obstet Gy-necol, 2008, 112(4):919-932.
[10]	Mastrobattista JM, Katz AR. Pregnancy after organ transplant[J]. Obstet Gynecol Clin North Am, 2004, 31(2):415-428. DOI URL
[11]	Punnoose LR, Coscia LA, Armenti DP, et al. Pregnancy outcomes in heart transplant recipients[J]. J Heart Lung Trans-plant, 2020, 39(5):473-480.
[12]	Ellenbogen KA, Thames MD, DiMarco JP, et al. Electrophysiological effects of adenosine in the transplanted human heart. Evidence of supersensitivity[J]. Circulation, 1990, 81(3):821-828. PMID
[13]	Abdalla M, Mancini DM. Management of pregnancy in the post-cardiac transplant patient[J]. Semin Perinatol, 2014, 38(5):318-325. DOI PMID
[14]	白铁娟, 秦璐, 董建秀, 等. 基于微信直播的正念训练对经皮冠状动脉介入治疗术后患者阈下抑郁症状的影响[J]. 中华护理杂志, 2022, 57(11):1304-1309. DOI
	Bai TJ, Qin L, Dong JX, et al. Effects of mindfulness training based on WeChat live broadcast on subthreshold depressive symptoms after PCI[J]. Chin J Nurs, 2022, 57(11):1304-1309. DOI

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1例心肺联合移植术后患者成功妊娠并分娩的护理

Successful pregnancy and delivery after heart and lung transplantation：a case report

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