Abstract:

This article summarizes the perioperative nursing experience of a patient with pituitary stalk interruption syndrome（PSIS） and decompensated cirrhosis who underwent allogeneic liver transplantation. The key nursing strategies included：establishing and implementing a cross-disciplinary dynamic hormone monitoring and stepwise sequential tapering regimen，with emphasis on preventing adrenal crisis；adopting a goal-directed fluid management strategy combined with quantitative titration of posterior pituitary hormone（vasopressin） to maintain water-electrolyte balance；establishing an integrated monitoring system for adverse drug effects to accurately differentiate between rejection and drug-related complications；and implementing a metabolic profile-based nutritional intervention to effectively correct refractory hypoalbuminemia. As a result，the patient did not develop severe complications such as adrenal crisis after liver transplantation and was discharged in stable condition on postoperative day 18. During 8 months of follow-up，the patient’s liver function and hormone levels remained stable.

Key words: Pituitary Stalk Interruption Syndrome, Liver Cirrhosis, Liver Transplantation, Hormone Replacement Therapy, Diabetes Insipidus, Perioperative Nursing

摘要：

总结1例垂体柄阻断综合征合并肝硬化失代偿期患者行同种异体肝移植的围手术期护理经验。护理要点如下：构建并执行跨团队动态激素监测与激素阶梯序贯递减治疗方案，重点预防肾上腺危象；实施以目标导向容量管理与垂体后叶素量化滴定为核心的管理策略，维持水电解质平衡；建立整合式药物副作用监测体系，精准鉴别排斥反应与药物相关并发症；基于代谢特点实施营养干预，有效纠正低蛋白血症。经上述系统性、预见性护理，患者术后未发生肾上腺危象等严重并发症，于术后第18天病情平稳后出院。随访8个月，患者的肝功能及激素水平稳定。

关键词: 垂体柄阻断综合征, 肝硬化, 肝移植, 激素替代疗法, 尿崩症, 围手术期护理