原位肝移植术后临床监测与处理

Clinical monitoring and treatment after orthotopic liver transplantation

目的 通过对原位肝移植术后患者的临床观察与处理 ,提高医护人员对肝移植术后患者的监护能力。方法 参照原位肝移植术后常用观察指标 ,对 4例原位肝移植患者术后进行严密监护、对比、分析。结果 1例术后 6天出血 ,1例拔除气管插管后 ,肺不张 ,2 4天后出现水痘 -带状疱疹病毒感染 ;1例术后二次插管、随后气管切开 ,并发ARDS;1例术后出现精神症状。结论 肝移植术后呼吸功能、循环功能、出血、感染、移植肝功能、排斥反应及精神心理反应是监护重点 ,对于患者安全度过术后危险期 ,提高近远期效果至关重要。

Objective To rise custodial ability by clinical observation and treatment after the orthotopic liver transplantation.Methods Refering to commonly used marker of liver transplantation,4 cases after liver transplantation were compared and analyzed.Results 1 case bled 6 days after operation; 1 case had non-expanded lung after pulling out tracheal cannula and occured chickenpox-bandlike herpesvirus infection 24 days after operation; 1 case had two times tracheal cannula and received windpipe-cutdown ensuring ARDS; 1 case had psychiatric symptoms.Conclusion Respiratory function,circulation function,bleeding,infection,remove liver function,rejection response and mind psyche response are the most imporement custodial point after liver transplantation. It is a key point to guarantee the patients safely passing through the post-operation period and improve prognosis.