原位肝移植术后早期限制性静脉补液的护理

Nursing of Controlled Fluid Infusion at Early Phase after Orthotopic Liver Transplantation

目的研究探讨肝移植术后静脉补液的适宜方法。方法选择于我院行原位肝移植治疗的12例患者,按入院先后随机分为限制性静脉补液组(干预组)和常规静脉补液组(对照组)。监测并记录手术当天至术后第5天的胸、腹水量,同时观察与心、脑、肺相关的并发症。结果术后1～5d,干预组患者的胸水、腹水量明显少于对照组(P<0.05);干预组出现并发症的比例明显少于于对照组(P<0.05)。结论避免过多的液体负荷是移植术后减少并发症的关键,限制性静脉补液有利于减轻肝移植术后患者早期胸腹水的积聚,有利于患者的早期康复。

Objective To explore the appropriate approaches of venous transfusion after liver trans- plantation. Methods Twelve patients who underwent orthotopic liver transplantations in the hospital were randomized into an experimental group（n = 7） receiving restrictive venous transfusion and a control group（n= 5） receiving routine venous transfusion. The volumes of patients ＇ ascites and pleural fluid were monitored and recorded from the day of operation to the 5th postoperative day. Besides, the complications linked to the heart, brain and lung were also recorded at the same time. Results During the period from the day of operation to the 5th postoperative day, the volumes of patients＇ ascites and pleural fluid in the experimental group were significantly less than those in the control group（P〈0.05）. Complication rates were significantly lower in experimental group than those in the control group （P〈 0. 05）. Conelusion It is crucial to avoid excessive transfusion fluid to decrease the complications after liver transplantation. Restrictive venous transfusion can reduce postoperative ascites and promote early recovery of the patients.