21例亲体肝移植供体受体围术期护理

Peri-operative Care to the Donors and Recipients Undergoing Living Donor Liver Transplantation

通过对21例活体肝移植供、受体围术期的观察和护理,认为术前对供体和受体做好充分有效的心理评估,进行有针对性的心理疏导和心理支持;针对供体为健康人群,术后应激反应重的特点,加强特护,严密观察生命体征,给予有效止痛,确保供体的安全和舒适;对受体术后严密监测各项生命体征,及时准确监测移植肝的功能,严密观察引流液的性质、颜色和量,以识别急性排斥反应、出血、胆漏、感染等并发症的先兆,做好预见性护理,并配合医生对并发症进行治疗和处理;同时监测抗排斥药物的血药浓度,及时发现药物不良反应并做好相应的护理措施是保证活体肝移植供、受体手术成功的关键。

By summarizing their experience in caring 21 living donors and recipients undergoing living donor liver transplantation, the authors think that the nursing key exists in preoperative mental assessment, pertinent mental instruction and mental support, intensified care for the donors and close observation of their vital signs according to the healthy donors＇ severe stress reaction, effective analgesia for the sake of donator safety; postoperative close observation of recipient＇s vital signs, close observation of quality, color and volume of drainage to identify the presymptoms of acute rejection, bleeding, biliary leakage, infection and etc, performance of predictive nursing, cooperation with doctors in treating complications, monitoring of concentration of blood anti-rejectives, and timely finding of adverse reaction of medicine.