胆道闭锁合并肺部感染患儿行血型不相容肝移植的护理

doi:10.3761/j.issn.2096-7446.2025.06.014

中华急危重症护理杂志 ›› 2025, Vol. 6 ›› Issue (6): 710-712.doi: 10.3761/j.issn.2096-7446.2025.06.014

胆道闭锁合并肺部感染患儿行血型不相容肝移植的护理

沈丹军(), 盛美君(), 郑虹, 叶飞亚, 冯佳艳

310052 杭州市国家儿童健康与疾病临床医学研究中心/浙江大学医学院附属儿童医院SICU（沈丹军，盛美君，郑虹，叶飞亚），国际医学部（冯佳艳）

收稿日期:2024-07-29 出版日期:2025-06-10 发布日期:2025-06-06
通讯作者: 盛美君，E-mail：smj512@zju.edu.cn
作者简介:沈丹军：男，本科（硕士在读），护师，E-mail：6518111@zju.edu.cn
基金资助:
浙江省教育厅一般科研项目(Y202354056)

Nursing care of a child with biliary atresia complicated with pulmonary infection undergoing blood group incompatible liver transplantation

SHEN Danjun(), SHENG Meijun(), ZHENG Hong, YE Feiya, FENG JiaYan

Received:2024-07-29 Online:2025-06-10 Published:2025-06-06

摘要/Abstract

摘要：

总结1例胆道闭锁合并肺部感染患儿行ABO血型不相容肝移植的护理体会。针对术前肺部感染严重，ABO血型不相容肝移植术后极易发生急性排斥反应、复杂血管并发症及感染风险等问题，采取多学科团队合作，构建全程链式管理模式，积极控制肺部感染，加强呼吸功能训练；主动降低血型抗体水平，做好预见性护理；早期序贯抗凝治疗，警惕血管并发症；高效序贯撤机治疗，做好经鼻高流量湿化氧疗的护理。通过开展儿童医疗辅导项目，缓解患儿负性情绪。经过39 d的治疗与护理，患儿顺利出院。

关键词: 肺部感染, ABO血型不相容, 肝移植, 胆道闭锁, 儿科护理学

Abstract:

To summarize the nursing experience of ABO incompatible liver transplantation in a child with biliary atresia complicated with pulmonary infection. In view of the severe pulmonary infection before surgery，ABO-incompatible liver transplantation was prone to acute rejection，complex vascular complications and infection risk，we adopted multidisciplinary collaboration to construct whole chain management mode，control lung infection actively，and strengthen respiratory function training，and reduced blood group antibody level actively and gave good predictive nursing. Early sequential anticoagulant therapy and being alert to vascular complications，high-efficient sequential weaning therapy and nasal high-flow humidified oxygen therapy nursing were implemented. We alleviated the negative emotion of the child through the medical counseling program for children. After 39 days of treatment and nursing，the child was discharged smoothly.

Key words: Pulmonary Infection, ABO Blood Group Incompatibility, Liver Transplantation, Biliary Atresia, Pediatric Nursing

沈丹军, 盛美君, 郑虹, 叶飞亚, 冯佳艳. 胆道闭锁合并肺部感染患儿行血型不相容肝移植的护理[J]. 中华急危重症护理杂志, 2025, 6(6): 710-712.

SHEN Danjun, SHENG Meijun, ZHENG Hong, YE Feiya, FENG JiaYan. Nursing care of a child with biliary atresia complicated with pulmonary infection undergoing blood group incompatible liver transplantation[J]. Chinese Journal of Emergency and Critical Care Nursing, 2025, 6(6): 710-712.

参考文献 8

[1]	中国研究型医院学会加速康复外科专业委员会. 儿童肝移植围手术期管理专家共识[J]. 中华外科杂志, 2021, 59(3):179-191.
	Enhanced Recovery After Surgery(ERAS) Committee of Chinese Research Hospital Association. Expert consensus of perioperative management in pediatric liver transplantation[J]. Chin J Surg, 2021, 59(3):179-191.
[2]	张晓峰, 朱震宇. ABO血型不相容肝移植策略[J]. 器官移植, 2024, 15(1):33-39.
	Zhang XF, Zhu ZY. ABO-incompatible liver transplantation strategies[J]. Organ Transplant, 2024, 15(1):33-39.
[3]	马思旻, 赖晓全, 覃凯. 肝移植患者术后肺部感染临床特征及其影响因素[J]. 中华医院感染学杂志, 2023, 33(9):1352-1356.
	Ma SM, Lai XQ, Qin K. Clinical characteristics and influencing factors of pulmonary infection after liver transplantation[J]. Chin J Nosocomiology, 2023, 33(9):1352-1356.
[4]	邓凤良, 方玉琦, 尹转,等. 基于信息—动机—行为技巧模型的链式管理对促进早产儿母乳喂养的效果评价[J]. 中华急危重症护理杂志, 2024, 5(5):446-451.
	Deng FL, Fang YQ, Yin C,et al. Effect of chain management based on information-motivation-behavior skill model on promoting breast-feeding in premature infants[J]. Chin J Emerg Crit Care Nurs, 2024, 5(5):446-451.
[5]	俞浩, 王卫利, 张微,等. 儿童ABO血型不相容肝移植围手术期处理的研究进展[J]. 中华外科杂志, 2023, 61(2):173-176.
	Yu H, Wang WL, Zhang W,et al. Progress in perioperative management of ABO-incompatible pediatric liver transplantation[J]. Chin J Surg, 2023, 61(2):173-176. doi: 10.3760/cma.j.cn112139-20220507-00206 pmid: 36720628
[6]	Jadaun SS, Saigal S, Agarwal S,et al. Practice of ABO-incompatible living donor liver transplant in India:an initial experience based on a survey[J]. J Clin Exp Hepatol, 2023, 13(5):927-929.
[7]	刘浩, 董钊彤, 杨阳,等. 经鼻高流量氧疗对比无创机械通气对有创机械通气序贯疗效的Meta分析[J]. 中国呼吸与危重监护杂志, 2022, 21(11):773-781.
	Liu H, Dong ZT, Yang Y,et al. Meta-analysis of sequential efficacy of intranasal high-flow oxygen therapy versus non-invasive mechanical ventilation in invasive mechanical ventilation[J]. Chin J Respir Crit Care Med, 2022, 21(11):773-781.
[8]	吴小花, 诸纪华, 周红琴,等. ICU儿童医疗辅导的研究进展[J]. 中华急危重症护理杂志, 2021, 2(5):448-453.
	Wu XH, Zhu JH, Zhou HQ,et al. Research progress of medical counseling for children in ICU[J]. Chin J Emerg Crit Care Nurs, 2021, 2(5):448-453.

[1]	周军, 陈阮, 诸纪华. 难治性支原体肺炎患儿并发右心室血栓与肺栓塞的护理[J]. 中华急危重症护理杂志, 2025, 6(6): 700-703.
[2]	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.
[3]	周军, 李帅妮, 朱胜男, 诸纪华. 终末期心力衰竭患儿植入左心室辅助装置的术后护理[J]. 中华急危重症护理杂志, 2025, 6(3): 335-338.
[4]	李天姿张慧芳黄月华莫红平蔡敏邱逸红. 肝移植受者围手术期营养支持的最佳证据总结[J]. 中华急危重症护理杂志, 2024, 5(6): 562-569.
[5]	王燕卢芳燕王芳吴君. 短肠综合征患儿小肠移植术后早期移植肠康复的护理[J]. 中华急危重症护理杂志, 2024, 5(5): 451-454.
[6]	金陈娣杨山凤严川川林楠李帅妮张泽伟诸纪华. 先天性左心室壁瘤行心室成形术患儿的护理[J]. 中华急危重症护理杂志, 2023, 4(9): 826-829.
[7]	何江娟叶志弘. 公民逝世后器官捐献肝移植受者术后感染的特点及护理进展 [J]. 中华急危重症护理杂志, 2023, 4(4): 371-.
[8]	王燕卢芳燕王芳. 丙酸血症患儿行亲体肝移植的术后护理 [J]. 中华急危重症护理杂志, 2023, 4(4): 347-.
[9]	戴蓉丁亚平夏姗姗. 川崎病休克综合征合并冠状动脉瘤及颅内出血患儿的护理 [J]. 中华急危重症护理杂志, 2023, 4(4): 343-.
[10]	卢露卢芳燕王樟辉陶玉侠姚彩萍张婉莹. 肝移植术后并发重度急性呼吸窘迫综合征患儿的护理 [J]. 中华急危重症护理杂志, 2023, 4(4): 328-.
[11]	周惠云罗飞翔慎斐赵一俊诸纪华. 泄殖腔外翻综合征早产儿的围手术期护理[J]. 中华急危重症护理杂志, 2023, 4(12): 1126-1129.
[12]	朱莉卢芳燕王芳傅来建王燕. 家族性高胆固醇血症患儿肝移植术后并发急性肝动脉血栓的护理[J]. 中华急危重症护理杂志, 2023, 4(12): 1122-1125.
[13]	卢露卢芳燕. 肝移植患儿术后并发早期肝动脉栓塞的护理[J]. 中华急危重症护理杂志, 2023, 4(11): 1030-.
[14]	卢露卢芳燕张婉莹姚彩萍. 童趣化护理在危重住院患儿护理中的应用进展 [J]. 中华急危重症护理杂志, 2022, 3(5): 477-480.
[15]	王燕卢芳燕王芳蒋树英朱莉. 先天性胆道闭锁短肠综合征患儿行肝移植的术后护理[J]. 中华急危重症护理杂志, 2022, 3(4): 351-.

胆道闭锁合并肺部感染患儿行血型不相容肝移植的护理

Nursing care of a child with biliary atresia complicated with pulmonary infection undergoing blood group incompatible liver transplantation

RichHTML

PDF下载

可视化

摘要/Abstract

引用本文

使用本文

参考文献 8

相关文章 15

编辑推荐

Metrics

本文评价