Abstract:

Summary of nursing experience was conducted in a case of emergency liver transplantation during the second trimester of pregnancy complicated by acute liver failure. The key nursing points are as follows：preoperative participation in multidisciplinary discussions and emergency plan desktop exercises；preparation of preoperative equipment and supplies. Intraoperative fetal protection at critical stages，prevention and management of hyperkalemia，correction of coagulation function，maintenance of circulatory stability，implementing anticipatory surgical coordination to curtail operative duration，and prevention of perioperative hypothermia under a proactive nursing model. Through multidisciplinary team collaboration and meticulous nursing care，the patient recovered well 8 days postoperatively and successfully delivered a female infant via cesarean section. The patient was transferred back to the general ward 8 days after the cesarean section and was discharged 47 days postoperatively. Follow-up for over 2 months showed good recovery for both the patient and the infant.

Key words: Acute Liver Failure, Mid Pregnancy, Liver Transplantation, Perioperative Nursing

摘要：

总结1例妊娠中期合并急性肝衰竭患者行紧急肝移植手术的护理经验。护理要点：术前参与多学科联合讨论，制订应急预案并进行桌面推演，做好术前设备及物品准备；术中全程关键节点胎儿保护，高钾血症预防及处理，纠正凝血异常，保证循环血容量稳定，实施预见性手术配合，缩短手术时间，同时采用前瞻性护理模式，做好围手术期低体温的预防。经过多学科协作救治及精细化护理，该患者于肝移植术后8 d行剖宫产术，顺利分娩1名女婴，术后47 d出院，出院后随访2月余，患者及婴儿恢复良好。

关键词: 急性肝衰竭, 妊娠中期, 肝移植, 围手术期护理