肝移植术后患者早期有效循环监测分析及护理对策

Research on circulation of blood monitor analysis and nursing countermeasures on liver-transplantation patients

目的了解肝移植患者术后24h内心率、血压及中心静脉压的变化规律，分析其影响因素，总结肝移植术后有效循环监测及护理措施，为规范肝移植术后护理程序提供依据。方法采用多功能心电监护仪，记录147例肝移植患者术前、术后返回ICU及术后2，6，12，24h等时间点心率、血压及中心静脉压，并进行统计分析。结果肝移植患者术后24h内的心率较术前明显加快（P〈0．01）；术后转入ICU后即刻血压较术前变化不大（P〉0．05），术后2h血压与术后入ICU时比较明显降低（P〈0．01），到术后24h有所回升；中心静脉压变化未见统计学意义（P〉0．05）。结论肝移植患者术后循环波动较大，应加强肝移植患者术后循环监测，给予预见性护理。

Objective To learn and analyze the patients＇ circulation of blood fluctuating rules in 24 hours after receiving the liver transplantation, conclude the policies of the circulation of blood monitor and nursing, and offer the basement for the clinical nursing program of liver transplanting. Methods Using the muhifunctional electrocardiograph to observe the liver-transplanted ICU patients＇ heart rate , blood pressure and center venous pressure in the time points below： before operation, turning back ICU immediately and 2、6、12、 24、20、24 hours, and make the statistical analysis. Results The patients＇ heart rate ascend greatly after entering ICU 24 hours（P 〈0. 01 ）. when turning back ICU, their blood pressure had no greatly different（P 〉 0. 05 ）. After 2 hours,the blood pressure become to distinct greatly until 24 hours. Center venous pressure had no statistical difference （ P 〉 0. 05 ）. Conclusions The liver-transplanted patients＇ circulation of blood changes greatly after operation. To avoid damage, we should strengthen the temperature monitor, and standardize the patient nursing management.