心脏死亡供体儿童肾移植的术后护理

Postoperative nursing of pediatric renal transplantation from cardiac death donors

目的 探讨心脏死亡供体儿童肾移植术后的护理特点及方法.方法 回顾性分析15例心脏死亡供体儿童肾移植的病历资料,总结相关护理特点及方法.结果 因供肾体积与受者体型的差异,2例移植肾放置于受者腹腔内,另13例放置在髂窝.13例受者在术后5d内肌酐接近正常水平,1例术后移植肾延迟功能恢复在术后20 d恢复正常,另1例患儿是8个月婴儿供肾在术后5个月肌酐正常.结论 心脏死亡供体儿童肾移植术后的护理有明显特殊性,护理人员除了根据患儿的特点展开围手术期常规医疗护理外,还应加强对术后的液体控制及腹胀的病情观察,预防排斥反应和感染的发生,做好出院的健康教育,保证患儿有良好的治疗依从性,是儿童肾移植取得成功的关键.

Objective To investigate the strategies of postoperative nursing of pediatric renal trans- plantation from donation after cardiac death. Methods A retrospective analysis of the clinical data of 15 children undergoing renal transplantation from cardiac death donors in our hospital was performed to sum- marize the postoperative nursing strategies. Results Due to mismatch of kidney graft volume and recipient size, the kidney grafts of two cases were placed in recipients abdominal cavity, and the other 13 cases were placed in the iliac fossa. 13 cases had the renal function recovered to normal serum creatinine within 5 days after transplantation. 1 case suffered delayed graft function （DGF） and graft function was returned to normal in 20 days.1 case of 8 months child suffered DGF and graft function was returned to normal condition in 5 months. Conclusions The postoperative nursing should be performed based on the characteristics of pediatric renal transplantation from cardiac death donors. In addition to perioperative routine nursing, fluid control and observation of postoperative abdominal distention, prevention rejection and infection, enhanced discharge health education to ensure compliance are critical to the success of pediatric renal transplantation.