背驮式肝移植围手术期神经精神并发症的处理

Perioperative management of psychiatric morbidities piggyback liver transplantation

目的探讨背驮式肝移植患者术后神经精神并发症的原因及临床应对。方法回顾性分析235例背驮式肝移植(PBLT)术后出现神经精神并发症的病因、治疗情况及临床对策。结果神经精神并发症发生率19.1%(45/235),其中以谵妄样精神障碍最为多见,但大多数症状不严重,均治愈,仅1例昏迷患者头颅CT检查证实有颅内出血,抢救无效后死亡。结论肝移植术后神经精神异常为常见并发症,医护人员加强识别、处理和心理辅导,采取严密观察,健康指导等,可提高患者的生存质量和治愈率。

[Objective] To study the causes and nursing strategy of psychiatric morbidities after piggyback liver transplantation. [Methods] Study the causes, management and nursing strategy of 235 cases of psychiatric morbidities after piggyback liver transplantation with retrospeetive analysis. [Results] The incidence of psyehiatrie morbidities after piggyback liver transplantation was 19.1%, among which delirium psyehogenia is the most common clinical events. Most of these cases are not serious and can be cured. Only 1 case died of brain bleeding diagnosed with CT after an effective rescuing process. [Conclusion] The psychiatric morbidities are very common complications after piggyback liver transplantation. Nursing faculty should recognize these morbidities and give psychological guidance, and pay more attention and health guidance to increase the postoperative survival rate and life qualities.