多支血管供肾在肾移植受体中的应用及围手术期护理

Application of Multi-vessel Feeding Kidney in Renal Transplant Recipients and Perioperative Nursing

目的分析多支血管供肾在肾移植受体中的应用效果,总结护理经验。方法 2018年1—5月,医院共多支血管供肾肾移植23例,纳入观察组,针对多支血管供肾肾移植特点,进行针对性的护理。2018年1月—2018年2月,医院单支血管供肾21例,纳入对照组,常规护理。对比住院时间,并发症发生情况,护理满意率等护理质量指标。结果观察组弃用1例。观察组住院时间(24.4±5.2)d,对照组(25.0±4.8)d,差异无统计学意义(t=0.397,P=0.694>0.05)。观察组的严重并发症发生率,消化道症状、睡眠障碍、心理应激发生率,护理满意率分别为9.5%、28.6%、28.6%、4.8%、85.7%,对照组则为20.8%、25.0%、29.2%、4.2%、83.3%,差异无统计学意义(χ~2=0.482、0.034、0.018、0.434、0.014,P=0.488、0.853、0.892、0.510、0.905>0.05)。观察组水电解质紊乱发生率8.3%低于对照组52.4%,差异有统计学意义(χ~2=10.064,P=0.002)。结论多支血管供肾在肾移植受体围术期护理需求存在自身的特点,对象护理质量尚可,严重并发症得到有效的控制,今后针对多支血管供肾肾移植对象需要建立系统化、规范化的护理对策。

Objective To analyze the application effect of multi-vessel feeding kidney in renal transplant recipients and summarize the nursing experience. Methods From January 2018 to May 2018, a total of 23 patients with renal and renal transplantation were enrolled in the hospital. The patients were enrolled in the observation group and targeted for muhi-vessel feeding kidney transplantation. From January 2018 to February 2018, 21 patients with single-vessel blood supply in the hospital were included in the control group for routine care. Compare the quality of care such as hospital- ization time, complications, and nursing satisfaction rate. Results The observation group abandoned 1 case. The hospital stay in the observation group （24.4±5.2）d, the control group （25.0±4.8）d, the difference was not statistically significant （t=0.397, P=0.694〉0.05）. The incidence of serious complications, gastrointestinal symptoms, sleep disorders, and psy- chological stress in the observation group were 9.5%, 28.6%, 28.6%, 4,8%, and 85.7%, and 20.8% and in the control group 25.0%, 29.2%, 4.2%, 83.3%, the difference was not statistically significant （X2=0.482, 0.034, 0.018, 0.434, 0.014, P=0.488, 0.853, 0.892, 0.510, 0.905〉0.05）. The incidence of water and electrolyte disturbance in the observation group was 8.3% lower than that in the control group （52.4%）, and the difference was statistically significant （X2=10.064, P=0.002）. Conclusion The muhi-vessel feeding kidney has its own characteristics in the perioperative nursing needs of renal transplant recipients. The quality of care in this group is acceptable, and serious complications are effectively controlled. In the future, it is necessary to establish a system for muhi-vessel feeding kidney transplantation and stan- dardized nursing strategies.