21例婴儿双供肾用于成人肾移植术的手术管理

Nursing care of en bloc kidneys transplantation from pediatric donors into 21 adult recipients

目的:总结21例婴儿双供肾成人肾移植手术的配合要点,包括婴儿供肾的获取和保存要点,婴儿供肾成人肾移植手术的术中配合。方法:回顾性分析2014年9月～2018年4月我院实施21例婴儿双供肾成人肾移植手术的临床资料,总结手术配合体会。结果:所有婴儿供肾获取过程顺利,后续完成21例婴儿双供肾成人肾移植手术。10例受者术后恢复顺利,11例受者术后分别并发肾动脉栓塞5例、肾静脉栓塞1例、超急性排斥反应1例、漏尿3例、外侧输尿管长段坏死1例。其中6例受者行保守治疗后转归良好,5例受者进行了二次肾移植术。结论:对于婴儿双供肾成人肾移植手术,良好的手术配合及管理有助于提高手术成功率。

Objective：To summarize the nursing points on en bloc kidneys transplantation from infant donors into 21 adult recipients,including the acquisition and preservation of donor kidneys,and the cooperation of kidney transplantation.Method：The clinical data of en bloc kidneys transplantation from pediatric donors into 21 adult recipients from September 2014 to April 2018 were retrospectively reviewed,and the experience of surgical cooperation was summarized.Result：All infant kidneys were harvested successfully.En bloc kidneys transplantation from pediatric donors into 21 adult recipients were subsequently completed.Ten of the recipients recovered well.Complications occurred in 11 recipients,included renal artery embolism in 5 cases,renal vein embolism in 1 case,hyperacute rejection in 1 case,urinary leakage in 3 cases and ureteral necrosis in 1 case.Six of the recipients with complication received good results after conservative treatment,but 5 recipients with complication were treated by reoperation.Conclusion：For en bloc kidneys transplantation from pediatric donors into adult recipients,agood surgical cooperation and management help to improve the success rate of surgery.