Abstract:

To summarize the nursing experience of a patient with recurrent upper gastrointestinal bleeding combined with acute antibody-mediated rejection after kidney transplantation. Nursing points：early identification of upper gastrointestinal bleeding，active prevention of hypovolemic shock；close observation of complications after blood transfusion；prevention of deep vein thrombosis and internal jugular vein thrombosis；providing staged nutritional support to maintain the stability of internal environment；early identification of acute antibody-mediated rejection and initiation of emergency plan；management of plasma exchange；precision nursing of immunosuppressive drugs；the whole process of psychological counseling was given to relieve the negative emotions of patients. After 81 days of active treatment and intensive care，the patient recovered and was discharged from the hospital.

Key words: Kidney Transplantation, Upper Gastrointestinal Hemorrhage, Acute Antibody-Mediated Rejection, Nursing Care

摘要：

总结1例肾移植术后合并急性抗体介导排斥反应患者的护理经验。护理要点：及早识别消化道出血，积极预防低血容量性休克；严密观察输血并发症；预防深静脉血栓及颈内静脉血栓；提供分阶段营养支持，维持内环境稳定；及早识别急性抗体介导排斥反应，启动应急预案；血浆置换的管理；免疫抑制药物精准化护理；全程心理疏导，缓解患者负性情绪。经过81 d积极治疗与精心护理，患者康复出院。

关键词: 肾移植, 上消化道出血, 急性抗体介导排斥反应, 护理