11例心脏死亡器官捐献肾移植患者围手术期护理对策分析

Perioperative nursing strategies analysis for 11 cases of renal transplantation from donation after cardiac death

目的探讨心脏死亡器官捐献(DCD)肾移植临床护理对策。方法回顾性分析安徽医科大学第一附属医院2013年7月至2015年5月实施DCD供体肾移植术11例患者的临床资料,总结DCD供体肾移植护理方法,观察患者术后有无急性排斥反应、移植肾功能延迟恢复(DGF)、感染、尿漏等并发症发生。结果 11例患者均手术顺利,术后7例肾功能恢复正常,DGF 4例,肺部感染2例,切口感染1例,尿漏1例,无急性排斥反应发生,无一例死亡。结论加强DCD供体肾移植围手术期护理,正确识别和判断术后并发症,及时采取有效的治疗和护理对策,可促进患者康复。

Objective To investigate the clinical nursing strategies of kidney transplantation from donation after cardiac death （DCD）. Methods The clinical data of 11 patients, underwent the DCD kidney transplantation in our hospital from Jul 2013 to May 2015, were retrospectively analyzed. The nursing strategies of DCD kidney transplantation were summarized, and such postoperative complications as acute rejection, delayed kidney function recovery, infection and urinary leakages in them were recorded. Results All 11 patients were operated successfully, and after operation, 7 cases recovered their renal function, 4 cases with delayed kidney function recovery, 2 cases with pulmonary infection, 1 case with incision infection and 1 case with urinary leakage. But no acute rejection was recorded, and no one died. Conclusion It should be necessary to strengthen the perioperative nursing of DCD kidney transplantation, so as to identify and diagnose the postoperative complications correctly and to take effective treatment and nursing strategies in time for promotion of the patients＇ recovery.