Ⅱ型Abernethy畸形合并肺动脉高压患者行肝移植的术后护理

doi:10.3761/j.issn.2096-7446.2025.05.013

中华急危重症护理杂志 ›› 2025, Vol. 6 ›› Issue (5): 579-581.doi: 10.3761/j.issn.2096-7446.2025.05.013

Ⅱ型Abernethy畸形合并肺动脉高压患者行肝移植的术后护理

申晓敏(), 贺文静(), 杨同男, 王丹丹, 赵文静

100218 北京市清华大学北京清华长庚医院肝脏ICU（申晓敏，杨同男），护理部（贺文静，王丹丹，赵文静）

收稿日期:2024-07-14 出版日期:2025-05-10 发布日期:2025-04-28
通讯作者: 贺文静，E-mail：hwja00089@btch.edu.cn
作者简介:申晓敏：女，本科，主管护师，E-mail：sxma0054@btch.edu.cn

Postoperative nursing of a patient with type Ⅱ Abernethy malformation complicated with pulmonary hypertension undergoing liver transplantation

SHEN Xiaomin(), HE Wenjing(), YANG Tongnan, WANG Dandan, ZHAO Wenjing

Received:2024-07-14 Online:2025-05-10 Published:2025-04-28

摘要/Abstract

摘要：

总结1例Ⅱ型Abernethy畸形合并肺动脉高压患者行肝移植术后静脉-动脉体外膜肺氧合（veno-arterial extracorporeal membrane oxygenation，VA-ECMO）护理体会。护理要点：围绕肝移植术后肺动脉高压病理生理特点，镇痛镇静的器官保护作用；靶向药物联合ECMO降低肺动脉压、改善右心功能；ECMO运转期间氧合监测与抗凝管理、下肢缺血等并发症的防控；个体化液体治疗避免新肝再灌注综合征。经过精细化护理团队在内的多学科协作，患者顺利康复出院。

关键词: Abernethy畸形, 门脉性肺动脉高压, 肝移植, 体外膜肺氧合, 危重病护理

Abstract:

To summarize the nursing experience associated with managing a patient diagnosed with type II Abernethy malformation complicated with pulmonary hypertension，who underwent liver transplantation followed by veno-arterial extracorporeal membrane oxygenation（VA-ECMO）. Based on the pathological and physiological characteristics of pulmonary hypertension following liver transplantation，analgesia and sedation was adopted to protect the organs. The targeted medications in conjunction with ECMO was used to reduce pulmonary artery pressure and improve right heart function. Monitoring oxygenation during ECMO operation along with anticoagulation management and prevention of complications such as lower limb ischemia，individualized fluid therapy to avoid new liver reperfusion syndrome were also implemented. Through meticulous nursing care and multidisciplinary collaboration，the patient successfully recovered and was discharged.

Key words: Abernethy Malformation, Portopulmonary Hypertension, Liver Transplantation, Extracorporeal Membrane Oxygenation, Critical Care Nursing

申晓敏, 贺文静, 杨同男, 王丹丹, 赵文静. Ⅱ型Abernethy畸形合并肺动脉高压患者行肝移植的术后护理[J]. 中华急危重症护理杂志, 2025, 6(5): 579-581.

SHEN Xiaomin, HE Wenjing, YANG Tongnan, WANG Dandan, ZHAO Wenjing. Postoperative nursing of a patient with type Ⅱ Abernethy malformation complicated with pulmonary hypertension undergoing liver transplantation[J]. Chinese Journal of Emergency and Critical Care Nursing, 2025, 6(5): 579-581.

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Ⅱ型Abernethy畸形合并肺动脉高压患者行肝移植的术后护理

Postoperative nursing of a patient with type Ⅱ Abernethy malformation complicated with pulmonary hypertension undergoing liver transplantation

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