总结1例复杂心脏畸形患者术后行心脏移植的围手术期护理体会。术前：落实心力衰竭分级监测与快速响应机制；基于患者解剖特征制订容量管理措施。术后：强化右心前、后负荷监测，预防右心衰竭；感染风险动态评估与精准拔除有创导管；高乳酸血症与高血糖的靶向干预；以回归社会为目标的康复训练。患者术后转入心外ICU，13 h后拔除气管插管，术后第4天顺利转回普通病房，住院27天痊愈出院。出院随访8个月，患者恢复良好。

This paper summarized perioperative nursing experience for a patient undergoing heart transplantation following complex cardiac malformation surgery. Preoperative measures included implementing graded heart failure monitoring and rapid response protocols，and developing volume management strategies tailored to the patient’s anatomical features. Postoperative care focused on strengthening right heart preload and afterload monitoring to prevent right heart failure，dynamic infection risk assessment with precise removal of invasive catheters，targeted interventions for hyperlactatemia and hyperglycemia，and rehabilitation training aimed at social reintegration. The patient was transferred to the cardiac surgery ICU，with tracheal intubation removed after 13 hours. On the 4th postoperative day，the patient was successfully transferred to a general ward and was discharged after 27 days of hospitalization. During the 8-month post-discharge follow-up，the patient recovered well.