肝移植术后肝动脉血栓形成的护理

Pathogeny of hepatic artery thrombosis after liver transplantation and the nursing strategies

目的总结肝移植术后肝动脉血栓形成(hepatic artery thrombosis,HAT)的护理方法。方法回顾性分析2007年1月-2009年12月本院598例实施成人肝移植患者的临床资料,其中14例出现HAT,总结HAT的治疗方法及护理要点。结果 6例患者行急诊肝动脉重建,6例行再次肝移植术,2例行肝动脉溶栓治疗;8例患者康复出院,6例因肝功能衰竭,严重感染而死亡。结论肝移植术后出现HAT患者死亡率高,应加强病情观察,重视凝血功能的监测,同时配合医生做好转氨酶升高及抗凝和溶栓治疗,其是提高治疗成功率的关键。

Objective To investigate the pathogeny of hepatic artery thrombosis（HAT） after liver transplantation and summarize the nursing experience.Methods The clinical data of 598 patients undergoing adult liver transplantations from January 2007 to December 2009 in our hospital were retrospectively analyzed.14 of them contracted HAT.The pathogeny of HAT was analyzed and the nursing experience was summarized.Results In the 14 cases of HAT,6 cases received hepatic artery reconstruction for emergency,another 6 cases received re-transplantation and the last 2 cases received thrombolytic therapy on hepatic artery.Finally,8 patients were discharged with rehabilitation,and the rest 6 died from liver failure and severe infection.Conclusions The mortality from HAT after liver transplantation is high.We should strengthen the observations on the patients,pay attention to the monitoring of coagulation and cooperate with doctors to perform liver-protecting therapy,anticoagulant therapy and thrombolytic therapy.That is the key to the improved success rate of treatment.