To summarize the nursing experience of a patient with intestinal infection and portal vein pneumatosis 5 years after renal transplantation. In view of the low body resistance caused by long-term use of immunosuppressive drugs,induced intestinal infection and hepatic portal vein pneumatosis,critical illness and rapid progress,it was necessary to quickly control infection and prevent intestinal ischemic necrosis,and adopt single isolation to prevent cross infection; adjust the use of immunosuppressive drug; implement sedation and analgesia; adopt anal expansion,enema,rectal finger stimulation,gastrointestinal decompression and others for conservative treatment of hepatic portal venous pneumatosis; give nutrition support therapy,and etc. After personalized treatment and nursing,the infection was controlled,the symptoms of hepatic portal vein pneumatosis disappeared,and the intestinal function recovered. The patients were transferred to the general ward on the 8th day after admission,and were discharged on the 14th day.
WANG Yawei
,
GAN Siyun
,
CHEN Kun
,
DENG Ronghua
,
YANG Zhiyan
. Nursing care of a patient with intestinal infection and portal vein pneumatosis after renal transplantation[J]. Chinese Journal of Emergency and Critical Care Nursing, 2022
, 3(6)
: 544
-546
.
DOI: 10.3761/j.issn.2096-7446.2022.06.014
[1] 田普训,薛武军,丁小明,等. 影响肾移植受者长期存活的多因素分析:单中心989例经验总结[J]. 中华器官移植杂志,2012, 33(12):706-709.
Tian PX,Xue WJ,Ding XM,et al.A multifactorial analysis on long-term survival of kidney transplantation recipients:a report of 989 cases in one centre[J]. Chin J Organ Transplant,2012, 33(12):706-709.
[2] Hermayer KL,Egidi MF,Finch NJ,et al.A randomized controlled trial to evaluate the effect of glycemic control on renal transplantation outcomes[J]. J Clin Endocrinol Metab,2012,97(12):4399-4406.
[3] Seak CJ,Hsu KH,Wong YC,et al.The prognostic factors of adult patients with hepatic portal venous gas in the ED[J]. Am J Emerg Med,2014,32(9):972-975.
[4] Gonda M,Osuga T,Ikura Y,et al.Optimal treatment strategies for hepatic portal venous gas:a retrospective assessment[J]. World J Gastroenterol,2020,26(14):1628-1637.
[5] 王振璞,蒋欣,苗书斋,等. 甲泼尼龙与醋酸泼尼松治疗肾移植术后肺部感染[J]. 实用医学杂志,2017,33(1):22-26.
Wang ZP,Jiang X,Miao SZ,et al.Prospective study of methylprednisolone and prednisone therapy for patients with pulmonary infection after renal transplantation[J]. J Pract Med,2017,33(1):22-26.
[6] Evans L,Rhodes A,Alhazzani W,et al.Surviving sepsis campaign:international guidelines for management of sepsis and septic shock 2021[J]. Intensive Care Med,2021,47(11):1181-1247.
[7] McClave SA,Taylor BE,Martindale RG,et al. Guidelines for the provision and assessment of nutrition support therapy in the adult critically ill patient[J]. JPEN J Parenter Enteral Nutr,2016,40(2):159-211.
[8] 何振扬. 2017 ESICM重症患者早期肠内营养指南解读[J]. 中华重症医学电子杂志(网络版),2018. 4(1):51-56.
He ZY.2017 ESICM guidelines for early enteral nutrition in critically ill patients[J]. Chin J Crit Care Med(online edition),2018,4(1):51-56.
[9] Puntillo KA,Max A,Timsit JF,et al.Determinants of procedural pain intensity in the intensive care unit. The Europain study[J]. Am J Respir Crit Care Med,2014,189(1):39-47.
[10] Devlin JW,Skrobik Y,Gélinas C,et al.Clinical practice gui-delines for the prevention and management of pain,agitation/sedation,delirium,immobility,and sleep disruption in adult patients in the ICU[J]. Crit Care Med,2018,46(9):e825-e873.
