总结1例肝移植术后并发耶氏肺孢子菌与巨细胞病毒感染致重度急性呼吸窘迫综合征的护理体会。针对患者肺部感染严重、用药护理复杂、体外膜肺氧合运行风险较大、康复过程漫长等多重难点，采取如下护理措施：制订集束化防护措施，积极防控继发感染；精细化用药护理，提升体外膜肺氧合治疗效能；多维度监测与护理，保障体外膜肺氧合安全运行；动态评估营养指标，实施阶梯式营养支持方案；开展早期康复锻炼，循序实施康复策略。经过积极治疗与护理，患者康复出院。

To summarize the nursing care of a patient who developed severe acute respiratory distress syndrome （ARDS） after liver transplantation due to co-infection with pneumocystis jirovecii and cytomegalovirus. To address multiple challenges including severe pulmonary infection，complex medication management，significant risks associated with extracorporeal membrane oxygenation（ECMO），and a prolonged recovery process，the following targeted interventions were implemented. Those included implementing bundled protective strategies to actively prevent secondary infections，refined medication management to enhance the efficacy of ECMO treatment，multidimensional monitoring and nursing care to sustain the safe operation of ECMO，dynamical assessment of nutritional indicators and a stepwise nutritional support plan，conducting early rehabilitation exercises and implementing phased recovery strategies. Through active treatment and meticulous nursing care，the patient recovered smoothly and was discharged.